<p>Patient Selection for Bronchoscopic Lung Volume Reduction</p>

Abstract

Purpose: Bronchoscopic lung volume reduction (BLVR) is a valuable treatment option for carefully selected patients with severe COPD. There is limited knowledge about the characteristics and outcomes of patients referred to a specialized center for BLVR. The study objectives were to investigate the selection rate for BLVR treatment in patients referred for this treatment and to investigate the differences between patients that were selected for BLVR and patients that were not. Patients and Methods: We performed a retrospective analysis of patients with severe COPD who were referred to our hospital to assess eligibility for BLVR treatment. Our parameters included demographics, comorbidity, chest computed tomography characteristics, reasons for rejection from BLVR treatment and patient survival. Results: In total, 1500 patients were included (mean age 62 years, 50% female and forced expiratory volume in 1 s 33% of predicted). Out of this group, 282 (19%) patients were selected for BLVR treatment. The absence of a suitable target lobe for treatment, an unsuitable disease phenotype and insufficient lung hyperinflation were the most important factors for not being selected. Patients that were selected for any BLVR option lived significantly longer than the group of patients that were not selected for BLVR (median 3060 versus 2079 days, P<0.001). Conclusion: We found that only a small proportion of patients that are referred for BLVR treatment is eligible for a BLVR treatment, indicating a need for both better referral tools and for the development of new therapies for this group of patients. Furthermore, our data suggest that selection for BLVR is associated with a significant survival benefit.

Crosslink bio-adhesives for bronchoscopic lung volume reduction: current status and future direction

“…For example, presence of collateral ventilation is an exclusion criterion for EBV treatment. A recent retrospective study by WELLING et al [33] further demonstrated the exclusivity of BLVR treatment. Out of all patients referred to BLVR, only 20% fulfilled the criteria for treatment, but these selected individuals upon treatment lived significantly longer than ineligible patients [33].…”

“…A recent retrospective study by WELLING et al [33] further demonstrated the exclusivity of BLVR treatment. Out of all patients referred to BLVR, only 20% fulfilled the criteria for treatment, but these selected individuals upon treatment lived significantly longer than ineligible patients [33]. Additionally, these therapeutic options have conferred benefits such as improved lung function and enhanced physical exercise capacity among COPD patients to varying extents, all leading to improved quality of life [7,8,15,23,34,35].…”

Survival in COPD patients treated with bronchoscopic lung volume reduction

“…Four hundred and fifty two (452) patients in this study were also included in the analysis previously reported on 1500 patients by Welling et al [9]. However, for the current study we included patients who visited our hospital and only included measurements performed in our hospital and not from the referring hospital as was previously done by Welling et al [9]…”

Bronchoscopic Lung Volume Reduction Operation and Pulmonary Rehabilitation

“…Clinically, dyspnea decreases, exercise capacity increases, and improvement in all components of quality of life is achieved [7]. In a retrospective study, it was reported that the cases who underwent BLVR had longer surveillance compared to those who did not receive BLVR [8].…”