Indications | Relative contraindications |
Clinical | |
Age <75 yrs | Age >75 yrs |
Disability despite maximal medical treatment including pulmonary rehabilitation | Comorbid illness with 5‐yr mortality >50% |
Exsmoker (>3 months) | Severe obesity or cachexia |
| Surgical constraint |
| α1‐Antitrypsin deficiency |
Physiological | |
FEV1 <35% pred | FEV1 >40% pred |
RV/TLC >60% | RV <150% pred |
TL,CO <20–40% pred | TLC <100% pred |
6MWD >300 m | Increased inspiratory resistance |
| TL,CO <20% pred |
| Pa,CO2 >55 mmHg |
| 6MWD <300 m |
| MPAP >35 mmHg |
Imaging | |
Severe heterogeneous emphysema on CT with upper lobe predominance | Minimal emphysemaSevere homogeneous emphysema |