Pulmonary Rehabilitation in Emphysema

Ries, Andrew L.; Make, Barry J.; Reilly, John J.

doi:10.1513/pats.200707-093et

Cited by 16 publications

(15 citation statements)

References 24 publications

(16 reference statements)

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“…Patients with severe emphysema remain significantly disabled despite pulmonary rehabilitation [6], optimum medical therapy [7] and long-term supplemental oxygen [8]. These therapies are not able to either reverse or remove the hyperinflation caused by the alveolar destruction, and therefore provide limited benefit.…”

mentioning

confidence: 99%

Radiological and clinical outcomes of using Chartis™ to plan endobronchial valve treatment

et al. 2012

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One-way endobronchial valves (EBVs) have been shown to relieve symptoms of emphysema, particularly in patients without collateral ventilation (CV) between the target and adjacent lobes. In this study, we investigated the ability of the bronchoscopic Chartis TM Pulmonary Assessment System to predict treatment response by determining the presence of CV.80 EBV patients underwent a pre-treatment Chartis assessment. Before and 30 days after implantation, high-resolution computed tomography scans were taken to determine target lobe volume reduction (TLVR). A pre-to post-treatment reduction of o350 mL was defined as significant. In addition, clinical outcomes (forced expiratory volume in 1 s (FEV1), 6-min walk test and St George's Respiratory Questionnaire) were compared over the same time period.Of the 51 patients classified as having an absence of CV according to their Chartis reading, 36 showed a TLVR o350 mL. 29 patients were classified as having CV, and of these 24 did not meet this TLVR cut-off. Chartis showed an accuracy level of 75% in predicting whether or not the TLVR cut-off would be reached. Those predicted to respond showed significantly greater TLVR (p,0.0001) and FEV1 improvement (p50.0013) than those predicted not to respond.Chartis is a safe and effective method of predicting response to EBV treatment.

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confidence: 99%

Radiological and clinical outcomes of using Chartis™ to plan endobronchial valve treatment

et al. 2012

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“…This is achieved by inserting slinky like metal coils to the damaged sections of the lung, restoring the elasticity and resulting in normal respiration. (-Doctors turning to metal coils for new emphysema treatment | CTV News,‖ n.d.) (Ries et al, 2008) Regenerative therapy is has given hope in development of damaged alveoli's. Matthew Hind and Malcolm Maden has envisaged the future application of embryonic stem cells for emphysema.…”

Section: Conclusion and Remarksmentioning

confidence: 99%

Are environmental toxins responsible for biochemical and physiological changes in emphysema?

Banerjee

Mansoori²,

Soni³

2017

IJMSCI

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Emphysema is a chronic, progressive form of a lung disease. Emphysema and chronic bronchitis both are grouped within the same disease state called as COPD, i.e. chronic obstructive pulmonary disease. It is one of the prevailing cause of morbidity and mortality in both developing and industrialized countries. There are several risk factors associated with emphysema, but, cigarette smoking is predominant factor leading to pathological variations in lung function. However, significant published literature also indicates that about 15% of all the cases of emphysema is environment-related with developing countries at highest risk. Although, there are many published literature regarding the risk factors, epidemiological evidences, diagnosis, management and prevention of emphysema, but very few explains the biochemical and physiological changes associated with environmental carcinogens. This review will help in further understanding the mechanism underlying the changes.

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“…Pulmonary rehabilitation in patients with severe emphysema is discussed further by Ries and coworkers (see pages 524-529, this symposium [24]). In addition, teaching the patients about chest physiotherapy and use of incentive spirometry preoperatively may reduce postoperative respiratory complications (6).…”

Section: Management Issues In Patients With Emphysema Undergoing Lvrsmentioning

confidence: 99%

Overview of the Perioperative Management of Lung Volume Reduction Surgery Patients

Sharafkhaneh¹,

Falk²,

Minai³

et al. 2008

Proceedings of the American Thoracic Society

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This article reviews management strategies that may improve the outcome of thoracic surgery and particularly lung volume reduction surgery (LVRS) in patients with severe emphysema. Maximal preoperative pharmacologic therapy includes bronchodilators and inhaled corticosteroids to attain peak lung function at the time of surgery. Nonpharmacologic measures include smoking cessation and pulmonary rehabilitation. Mechanical ventilation during the perioperative period should ensure adequate oxygenation, while avoiding dynamic hyperinflation. Keys to successful postoperative care include close monitoring while in the intensive care unit, early extubation, adequate pain control, chest physiotherapy and appropriate chest tube management. Aggressive management of early postoperative complications, including air leaks, respiratory failure, arrhythmias, and hemorrhage, can also be expected to improve outcomes.

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Pulmonary Rehabilitation in Emphysema

Cited by 16 publications

References 24 publications

Radiological and clinical outcomes of using Chartis™ to plan endobronchial valve treatment

Radiological and clinical outcomes of using Chartis™ to plan endobronchial valve treatment

Are environmental toxins responsible for biochemical and physiological changes in emphysema?

Overview of the Perioperative Management of Lung Volume Reduction Surgery Patients

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