Bronchoscopic lung volume reduction procedures for chronic obstructive pulmonary disease

Abstract

Results for selected BLVR procedures indicate they can provide significant and clinically meaningful short-term (up to one year) improvements in health outcomes, but this was at the expense of increased adverse events. The currently available evidence is not sufficient to assess the effect of BLVR procedures on mortality. These findings are limited by the lack of long-term follow-up data, limited availability of cost-effectiveness data, significant heterogeneity in results, presence of skew and high CIs, and the open-label character of a number of the studies.

Bronchoscopic lung volume reduction: recent updates

“…Additional improvements in lung function were found, including a decrease in RV, improvement in FVC and reduction of RV/TLC ratio, although these end points were less commonly reported (5). No significant difference in TLC was found, and DLCO values were not reported.…”

“…There was no difference in DLCO (5). Whereas in one study the number of adverse events was higher for participants in the intervention group [OR 3.41 (1.48-7.84)] (5), including COPD exacerbations, respiratory failure, pneumonia and bronchospasm, the Ninane study (14) showed no significant difference in adverse events.…”

“…Additional improvements in lung function were found, including a decrease in RV, improvement in TLC, reduction of RV/TLC and improvement of diffusion capacity of lungs for carbon monoxide (DLCO), although these end points were not routinely reported (5).…”

GOLD 2017 recommendations for COPD patients: toward a more personalized approach

“…On the contrary, endobronchial valve therapy is not useful in patients with lack of fissure integrity or if interlobar collateral ventilation is present. Overall, it seems that these procedures can improve clinical health outcomes, although with a non-negligible rate of adverse events [51].…”

Valvular Bronchial Closure in the Treatment of Bronchopleural Fistulas

“…Внедрённая в клиническую практику методика кла-панной бронхоблокации, которая активно исполь-зуется во фтизиохирургии для лечения пациентов с хронической обструктивной болезнью лёгких, при-меняется и в практике торакальных отделений [2,3,5,6,11,13,14,15,16,17].…”