Abstract
Background: Patients with severe chronic obstructive pulmonary disease (COPD) have limited treatment options. Exercise capacity and health related quality of life (HRQL) of these patients are affected by the progress of respiratory failure. Thus, there is a need for new treatments that can palliate. Endo-bronchial volum reduction treatment (EBVRT) which is a minimally invasive method has been come up. Endobronchial valves (EBV) that allow air to escape from a pulmonary lobe but not enter. It can induce a reduction in lobar volume that may thereby improve lung function and exercise tolerance in patients with advanced emphysema.
Method: To evaluate the safety and effectiveness of the EBVRT of lower lobe predominant heterogeneous emphysema. Functional capacity was evaluated with spirometry, 6minute walk distance (6MWD). SGRQ were applied to evaluate the HRQL.
Result: Five patients with heterogeneous lower lobe predominant emphysema (two left, three right lower lobe) were treated with EBV. Most of the patients were male (80%). The mean age was 65 years. Valves were placed into left lower lobe (n=2) and right lower lobes (n=3). Valves were placed in airways with 100% technical success. There were no procedure-related deaths and complications. At the third month, there was an increase of 4.6% in the forced expiratory volume 1 second (FEV1) and 2.3% increase of 6MWD were observed. Also, there was a decrease of 2.3% in the SGRQ score was observed.
Conclusion: EBVRT for heterogeneous lower lobe predominant emphysema patients induced modest improvements in lung function, exercise tolerance, and HRQL. EBVRT is a new safety method for the patients with severe COPD.
- © 2011 ERS