Rationale and design of the national emphysema treatment trial (NETT): A prospective randomized trial of lung volume reduction surgery

Piantadosi, Steven; Rodarte, Julio J.; Miller, Christopher J.; Barnard, Philip; Carter, J.; DuBose, Katrina D.; Flanigan, Timothy P.; Fox, Paige M.; Haddad, John L.; Hale, Kathryn; Jahn, A.; King, Karen E.; Nguyen, Cao; Norman, Sarah E.; Officer, Thomas P.; Reardon, Michael J.; Ricketts, Jessie; Sax, Steven L.; Tucker, Margaret G.; Williams, Kendra N.; Dj, Sugarbaker; Fanning, Cora A.; Birkenmaier, K.; Body, Simon C.; Catanzano, C; Duffy, Sean; Formanek, V.; Fuhlbrigge, Anne L.; Hartigan, Pamela; Hunsaker, Andetta R.; Jacobson, Francine L.; Mark, Lynette; Russell, R. Patterson; Saunders, Deanna; Simons, Gary; Swanson, Seegar; McKenna, Robert J.; Mohsenifar, Zab; Geaga, C.; Aberle, David F.; Brown, Janice; Clark, S. A.; Cooper, C.B.; Ferrill, R.; Frantz, Robert P.; Gelb, Arthur F.; Goldin, Jonathan G.; Gordon, Jacqueline; Head, David R.; Joyner, Mary; Julien, Pierre; Levine, Mitchell; Lewis, Mitra; Pendio, M.; Silverman, Julian; Walker, Pieter; Williams, Brian; Yegyan, V.; Yoou, C.; Maurer, Jürgen; DeCamp, Malcolm M.; Meli, Yvonne; Aviv, L.; Hearn, Charles; Kraenzler, Erik J.; Marlow, Scott; McCarthy, Keith; Mehta, Ankit I.; Meziane, Moulay; O’Donovan, Peter; Schilz, Robert; Sullivan, Erin A.; Ginsburg, Mark E.; Scharf, Steven M.; Jellen, Patricia A.; Asegu, A.; Austin, James D.; Bartels, Mathew N.; Berkman, Y.; Berkoski, P.; Brogan, Frances; Delphin, Ellise; Demercado, G.; DiMango, Angela; DePrisco, L.; Gonzales, Jon C.; Gotthelf, J.; Herman, Patricia M.; Khan, Afaq Ahmad; Mantinaos, M.; McKEON, Kerri; Mets, Berend; Pearson, G E; Pfeffer, J.; Rossoff, Leonard J.; Sunshine, Abraham; Simonelli, P.; Stavrolakes, Kim; Thomashow, Byron

doi:10.1016/s0022-5223(99)70191-1

Cited by 122 publications

(4 citation statements)

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“…Patients were selected according to the NETT study’s criteria. [ 14 ] Patients with FEV1 values in the GOLD 3–4 class and corresponding to group E in the COPD combined assessment modality were included in this study. In a study conducted by Darwiche and Aigner.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…To summarize the NETT study criteria: Presence of HRCT-proven bilateral emphysema, stable disease with a maximum of 20 mg prednisone (or equivalent) daily, Forced expiratory volume in 1 second (FEV1) value ≤45% and ≥15% of predicted value, TLC value ≥100% of predicted value, RV value ≥150% of predicted value on PFT, PCO2 ≤60 mm Hg and PO2 ≥45 mm Hg in room air in arterial blood gas, 6-min walk ≥140 meters after rehabilitation, the patient had not smoked for 4 months and had completed a pulmonary rehabilitation program. [14] Our inclusion criteria for the study were those older than 35 years of age, post-bronchodilator predicted FEV1≤45%, homogeneous or heterogeneous emphysema on HRCT, RV predicted >175%, TLC >100% predicted, and who had quit smoking 8 weeks ago. Exclusion criteria are pregnancy, lactation, recurrent respiratory tract infection, giant bullae constituting >1/3 of the lung volume, presence of lung cancer, presence of clinically significant bronchiectasis, volume reduction surgery, transplantation or lobectomy, 6-MWT <140 m, history of steroid use 20 mg/ day and those with vessels that visually exceed the size of the adjacent airway.…”

Section: Methodsmentioning

confidence: 99%

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Efficiency and Reliability of Bronchoscopic Lung Volume Reduction Coil Application in Patients with Severe Emphysema

Kayikci

2023

Sisli Etfal

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Objectives In the past years, surgery has been used for the non-medical treatment of severe emphysema. However, in recent years, bronchoscopic lung volume reduction (LVR) treatment has become more preferred because it is less invasive. Bronchoscopic coil treatment is the most frequently applied technique among these methods. The aim of the investigation was to determine the efficacy and safety of bronchoscopic volume reduction coil treatment for patients with severe emphysema. Methods The patients who were performed bronchial volume reduction coil treatment between 2015 and 2017 and were followed in our outpatient clinic were retrospectively examined. They were followed for 1 year at quarterly intervals after the procedure. All the safety and efficacy of the patient’s records, including the modified Medical Research Council (MRC) dyspnea score, the St. George’s Respiratory Questionnaire (SGRQ) quality of life scale, the 6 min walk distance (6-MWT), pulmonary function tests, and adverse events, were evaluated. Results Sixteen patients were included in the study. The mean of the preoperative mMRC clinic dyspnea score was 3.38, the mean of the 3rd month’s mMRC score was 2.62 (p=0.007), and the mean of the 12th month’s mMRC was 2.37 (p=0.003). The preoperative SGRQ quality of life parameter was 71.95±15.7, the 3 rd month was 66.7±16.2 (p=0.007), and the 12 th month was 62.9±16.4 (p=0.003). Preoperative mean of 6-MWT was 247.25±112.36 m, 3 rd month 264.25±95 m (p=0.148), and 12 th month 317±122.9 m (p=0.034). Patients’ preoperative residual volume was 5.28±1.96 L, 3 rd month 4.52±1.35 L (p=0.023), and 12 th month 4.545±1.83 L (p=0.163). Patients’ preoperative forced expiratory volume in one second, respectively, was 0.79±0.29 L, 3 rd month 0.79±0.3 L (p=0.917), and 12 th month 0.86±0.3 L (p=0.756). Conclusion It seems that bronchoscopic LVR coil treatment, which is an effective and reliable procedure that reduces shortness of breath rather than respiratory function test parameters and improves the quality of daily life, will become even more widespread.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Efficiency and Reliability of Bronchoscopic Lung Volume Reduction Coil Application in Patients with Severe Emphysema

Kayikci

2023

Sisli Etfal

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“…Actually, lung volumes such as FRC or IC have been shown to correlate better than FEV 1 with patient-centered outcomes such as dyspnea, exercise tolerance, and HRQoL [20,21,22]. Although, lung volume measurement is not routinely recommended for COPD patients, it is a prerequisite preoperative evaluation tool for severe COPD patients who are considered for lung volume reduction surgery or bronchoscopic lung volume reduction [23,24]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Utility of Computed Tomographic Lung Volumes in Patients with Chronic Obstructive Pulmonary Disease

Lee

Lee²,

Seo³

et al. 2013

Respiration

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Background: Published data concerning the utility of computed tomography (CT)-based lung volumes are limited to correlation with lung function. Objectives: The aim of this study was to evaluate the clinical utility of the CT expiratory-to-inspiratory lung volume ratio (CT V_ratio) by assessing the relationship with clinically relevant outcomes. Methods: A total of 75 stable chronic obstructive pulmonary disease (COPD) patients having pulmonary function testing and volumetric CT at full inspiration and expiration were retrospectively evaluated. Inspiratory and expiratory CT lung volumes were measured using in-house software. Correlation of the CT V_ratio with patient-centered outcomes, including the modified Medical Research Council (MMRC) dyspnea score, the 6-min walk distance (6MWD), the St. George's Respiratory Questionnaire (SGRQ) score, and multidimensional COPD severity indices, such as the BMI, airflow obstruction, dyspnea, and exercise capacity index (BODE) and age, dyspnea, and airflow obstruction (ADO), were analyzed. Results: The CT V_ratio correlated significantly with BMI (r = −0.528, p < 0.001). The CT V_ratio was also significantly associated with MMRC dyspnea (r = 0.387, p = 0.001), 6MWD (r = −0.459, p < 0.001), and SGRQ (r = 0.369, p = 0.001) scores. Finally, the CT V_ratio had significant correlations with the BODE and ADO multidimensional COPD severity indices (r = 0.605, p < 0.001; r = 0.411, p < 0.001). Conclusion: The CT V_ratio had significant correlations with patient-centered outcomes and multidimensional COPD severity indices.

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Sex, Depression, and Risk of Hospitalization and Mortality in Chronic Obstructive Pulmonary Disease

et al. 2007

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Background:We sought to determine whether depressive or anxiety symptoms are associated with chronic obstructive pulmonary disease (COPD) hospitalization or mortality. These data were collected as part of the National Emphysema Treatment Trial (NETT), a randomized controlled trial of lung volume reduction surgery vs continued medical treatment conducted at 17 clinics across the United States between January 29, 1998, and July 31, 2002.Methods: Prospective cohort study among participants in the NETT with emphysema and severe airflow limitation who were randomized to medical therapy. Primary outcomes were 1-and 3-year mortality, as well as COPD or respiratory-related hospitalization or emergency department visit during the 1-year follow-up period. Of 610 patients randomized to medical therapy, complete data on hospitalization and mortality were available for 3 years of follow-up for 603 patients (98.9%).Results: Depressive symptoms were assessed using the Beck Depression Inventory (BDI) questionnaire, and anxi-ety was assessed using the State-Trait Anxiety Inventory. Among 610 subjects, 40.8% had at least mild to moderate depressive symptoms. Patients in the highest quintile of BDI score (BDI score, Ն15) had an increased risk of respiratory hospitalization in unadjusted analysis compared with patients in the lowest quintile (BDI score, Ͻ5) (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.30-3.93). After adjustment for disease severity, this relationship was no longer statistically significant. The adjusted risk of 3-year mortality was increased among those in the highest quintile of BDI score (OR, 2.74; 95% CI, 1.42-5.29) compared with those in the lowest quintile. Anxiety was not associated with hospitalization or mortality in this population.Conclusions: Depressive symptoms are common in patients with severe COPD and are treated in few subjects. Depressive symptoms are associated with increased risk for 3-year mortality but not 1-year mortality or hospitalization.

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Rationale and design of the national emphysema treatment trial (NETT): A prospective randomized trial of lung volume reduction surgery

Cited by 122 publications

References 31 publications

Efficiency and Reliability of Bronchoscopic Lung Volume Reduction Coil Application in Patients with Severe Emphysema

Efficiency and Reliability of Bronchoscopic Lung Volume Reduction Coil Application in Patients with Severe Emphysema

Clinical Utility of Computed Tomographic Lung Volumes in Patients with Chronic Obstructive Pulmonary Disease

Sex, Depression, and Risk of Hospitalization and Mortality in Chronic Obstructive Pulmonary Disease

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