Change in Dynamic Hyperinflation After Bronchoscopic Lung Volume Reduction in Patients with Emphysema

Autor: Marlies van Dijk, Karin Klooster, Jorine E. Hartman, Nick H. T. ten Hacken, Dirk-Jan Slebos
Přispěvatelé: Groningen Research Institute for Asthma and COPD (GRIAC)
Rok vydání: 2020
Předmět:
Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Standard of care
Outcome Assessment
Health Care/methods
Tomography
X-Ray Computed/methods
Hyperinflation
Walk Test
Bronchoscopic Lung Volume Reduction
Tachypnea
Severity of Illness Index
Bronchoscopic lung volume reduction
Lung/diagnostic imaging
Respiratory Function Tests/methods
Inspiratory Capacity
Internal medicine
Outcome Assessment
Health Care
Medicine
Humans
COPD
In patient
Pulmonary Emphysema/diagnosis
Dynamic hyperinflation
Pneumonectomy/adverse effects
Pneumonectomy
Tomography
Lung
Netherlands
Emphysema
business.industry
Walk Test/methods
Outcome Assessment
Health Care/methods
Middle Aged
medicine.disease
Lung Volume Measurements/methods
X-Ray Computed/methods
Respiratory Function Tests
Residual Volume
Pulmonary Emphysema
Cardiology
Female
medicine.symptom
business
Lung Volume Measurements
Tomography
X-Ray Computed
Zdroj: Lung
Lung, 198(5), 795-801. SPRINGER
ISSN: 1432-1750
0341-2040
Popis: Background and Purpose In patients with severe emphysema, dynamic hyperinflation is superimposed on top of already existing static hyperinflation. Static hyperinflation reduces significantly after bronchoscopic lung volume reduction (BLVR). In this study, we investigated the effect of BLVR compared to standard of care (SoC) on dynamic hyperinflation. Methods Dynamic hyperinflation was induced by a manually paced tachypnea test (MPT) and was defined by change in inspiratory capacity (IC) measured before and after MPT. Static and dynamic hyperinflation measurements were performed both at baseline and 6 months after BLVR with endobronchial valves or coils (treatment group) or SoC (control group). Results Eighteen patients underwent BLVR (78% female, 57 (43–67) years, FEV1 25(18–37) %predicted, residual volume 231 (182–376) %predicted). Thirteen patients received SoC (100% female, 59 (44–74) years, FEV1 25 (19–37) %predicted, residual volume 225 (152–279) %predicted. The 6 months median change in dynamic hyperinflation in the treatment group was: + 225 ml (range − 113 to + 803) (p p = 0.422). An increase in dynamic hyperinflation was significantly associated with a decrease in residual volume (r = − 0.439, p Conclusion Bronchoscopic lung volume reduction increases the ability for dynamic hyperinflation in patients with severe emphysema. We propose this is a consequence of improved static hyperinflation.
Databáze: OpenAIRE
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