Bronchial Thermoplasty Including the Middle Lobe Bronchus Significantly Improves Lung Function and Quality of Life in Patients Suffering from Severe Asthma.

Autor: Eisenmann S; Interventional Pneumology, Ruhrlandklinik-West German Lung Center, Essen, Germany. stephan.eisenmann@uk-halle.de.; Department of Pulmonary Medicine, University of Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle, Germany. stephan.eisenmann@uk-halle.de., Schütte W; Martha-Maria Hospital Halle-Dölau, Halle, Germany., Funke F; Interventional Pneumology, Ruhrlandklinik-West German Lung Center, Essen, Germany., Oezkan F; Interventional Pneumology, Ruhrlandklinik-West German Lung Center, Essen, Germany., Islam S; Interventional Pulmonology, Ohio State University, Columbus, USA., Darwiche K; Interventional Pneumology, Ruhrlandklinik-West German Lung Center, Essen, Germany.
Jazyk: angličtina
Zdroj: Lung [Lung] 2019 Aug; Vol. 197 (4), pp. 493-499. Date of Electronic Publication: 2019 May 27.
DOI: 10.1007/s00408-019-00240-5
Abstrakt: Purpose: Bronchial Thermoplasty (BT) is indicated in patients suffering from severe and symptomatic bronchial asthma despite maximal medical therapy. However, treatment of the right middle lobe (RML) bronchus is currently not recommended. The aim of this study was to investigate the safety and efficacy of BT if the RML bronchus is included.
Methods: BT was performed in 17 consecutive patients, quality of life and pulmonary function were characterized before and 90 days after BT completion. Furthermore, we performed a clean-up bronchoscopy following every BT. This study was approved by the IRB of the University of Essen (No. 17-7356 BO) and registered as a retrospective observational study at the German Clinical Trials Registry (No. DRKS 00011550).
Results: The median baseline values of FEV1 and Asthma Questionnaire of Life Quality (AQLQ) were 1.33 l (0.91; 1.73) and 3.01 (2.76; 3.61), respectively, and significantly improved 90 days after treatment with FEV 1 at 1.75 l (p-value 0.002) and AQLQ 3.8 (p-value < 0.05). Also the amount of oral corticosteroid necessity decreased significantly. No severe adverse events occurred due to the procedure. Clean-up bronchoscopies-when performed-revealed significant fibrinous exudation after every BT procedure.
Conclusion: BT including the RML bronchus is feasible. Functionally limited patients with severe asthma could potentially profit. Due to the relevant fibrinous exudation, BT should be followed by clean-up bronchoscopy, not only after RML treatment.
Databáze: MEDLINE
Externí odkaz: