Lung volume reduction surgery in a ventilator-dependent patient

Abstract

In recent years lung volume reduction surgery (LVRS) has been advocated in a selected group of severe chronic obstructive pulmonary disease (COPD) patients. There are few reports of successful surgical intervention on ventilator-dependent patients. We present our own experience with a 53-year-old male who suffered an acute exacerbation of COPD and who could not be weaned off ventilation after 22 days. He underwent bilateral LVRS after which he was successfully weaned from ventilation. He is alive 4 years later with a satisfactory quality of life.

Endoscopic lung volume reduction effectively treats acute respiratory failure secondary to bullous emphysema

“…The benefits of lung volume reduction surgery (LVRS) for emphysema are well established, with a large randomized controlled trial showing improved mean exercise capacity, and increased survival in a subgroup with upper‐lobe‐predominant disease and poor baseline exercise capacity 1 . However, LVRS is associated with significant perioperative morbidity and mortality, 2 and the literature on its use in mechanically ventilated patients is limited to case reports 3–5 . Pre‐transplant ventilator dependence is associated with poor outcomes among lung transplant recipients 6,7 .…”

“…The LVRS has been used successfully to treat a ventilator‐dependent patient with severe emphysema 3 . Emergent use of EBV has been reported in a single lung transplant recipient, where 17 Emphasys Zephyr valves were placed to treat acute respiratory failure due to native lung hyperinflation, by collapsing the native lung 22 .…”