The role of a multidisciplinary severe chronic obstructive pulmonary disease hyperinflation service in patient selection for lung volume reduction

Abstract

Chronic obstructive pulmonary disease (COPD) is a complex disease and the management is focused on improving breathlessness, quality of life and healthcare utilisation. Our understanding of COPD phenotypes has improved in recent years and there is an increased drive towards delivering phenotypebased therapies. Lung volume reduction can offer the prospect of life changing benefit in breathlessness and quality of life in a select group of patients with severe emphysema already receiving maximum medical treatment. In spite of the available evidence, very few procedures are being performed relative to the disease burden and prevalence of suitable individuals. Currently the major barriers to patient accessibility are lack in standardised multidisciplinary severe COPD services with easy access to lung volume reduction procedures, as well as poorly informed perceptions of healthcare professionals. There is a recognised need to improve such services in many healthcare systems. We share our experiences with setting up and running a successful regional multidisciplinary severe COPD hyperinflation service.

Endobronchial Valves for the Treatment of Advanced Emphysema

“…Basic elements for a successful program are dedication, COPD expert knowledge, access to interventional pulmonology, access to multimodality treatments for COPD (other bronchoscopic and surgical LVR techniques, 47 pulmonary rehabilitation, noninvasive ventilation, and lung transplantation), 21 , 48 well-organized in-house logistics and facilities (radiology, pulmonary function testing, anesthesia, thoracic surgery), and a solid referral network. Participation in scientific efforts can be important for advancing the BLVR field and getting the exposure needed for patient referrals.…”

“…Only by doing this can you ensure the best possible treatment is offered to each individual patient with COPD. 21 , 42 , 48 As an expert center, we offer other hospitals the chance to discuss potential cases using a weekly scheduled videoconferencing meeting. By organizing this, we educate referral and other treatment hospitals to prevent them from the pitfalls we previously encountered, thereby ensuring high quality standards.…”

Terapi komplementer non invasif pada peningkatan status kesehatan sistem pernapasan penderita PPOK: Sebuah literature review

“…Tujuan rehabilitasi paru adalah untuk memperbaiki kondisi fisik dan psikis orang dan untuk mempromosikan kepatuhan jangka panjang dari perilaku yang meningkatkan kesehatan. Hal ini adalah komponen kunci dari manajemen multi-disiplin PPOK, dapat meningkatkan kemampuan olahraga, menurunkan dispnea, meningkatkan aktivitas kehidupan seharihari, kekuatan otot, dan self-efficacy (Houchen-Wolloff et al, 2018;Chew & Mahadeva, 2018). Tinjauan sistematis baru-baru ini juga menunjukkan bahwa rehabilitasi paru dapat meningkatkan kualitas hidup (W. H. Liao et al, 2015).…”

Bronchoscopic interventions for severe emphysema: Where are we now?

“…19,45,47,71 Hence, patients should be carefully evaluated and discussed in a multidisciplinary setting so that the most effective treatment option for the individual patients is offered. 72,73 The Authors:…”