University of Oklahoma Health Sciences Center

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Author/s:

Abia-Trujillo, David, Johnson, Margaret M, Patel, Neal M, Hazelett, Britney, Eric S Edell, Kern, Ryan

Date Added:

August 31, 2020

Journal/Publication:

Mayo Clinic proceedings

Publication Date:

August 20, 2020

URL:

Bronchoscopic Lung Volume Reduction: A New Hope for Patients With Severe Emphysema and Air Trapping

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

doi: 10.1016/j.mayocp.2020.03.027

MeSH

Residual Volume

Pneumonectomy

Cost-Benefit Analysis

cause of death

Pulmonary Emphysema

pulmonary disease, chronic obstructive

Lung Volume Measurements

Lung

Dyspnea

Emphysema

referral and consultation

RPR Commentary

This relatively new procedure is probably worth knowing about. I’m not sure where, other than Mayo, it is being done. James W. Mold, MD, MPH

Abstract

Chronic obstructive pulmonary disease (COPD) is common and has significant morbidity and mortality as the fourth leading cause of death in the United States. In many patients, particularly those with emphysema, COPD is characterized by markedly increased residual volume contributing to exertional dyspnea. Current therapies have limited efficacy. Surgical resection of diseased areas of the lung to reduce residual volume was effective in identified subgroups but also had significant mortality in and suboptimal cost effectiveness. Lung-volume reduction, using bronchoscopic techniques, has shown substantial benefits in a broader patient population with less morbidity and mortality. This review is meant to spread the awareness about bronchoscopic lung-volume reduction and to promote its consideration and early referral for patients with advanced COPD and emphysema frequently encountered by both primary care physicians and specialists. A search was conducted on PubMed (MEDLINE), EMbase, and Cochrane library for original studies, using the following keywords: "lung-volume reduction." "endobronchial valves," "intrabronchial valves," "bronchoscopic lung-volume reduction," and "endoscopic lung-volume reduction." We included reports from systematic reviews, narrative reviews, clinical trials, and observational studies. Two reviewers evaluated potential references. A total of 27 references were included in our review. Included studies report experience in the diagnosis and bronchoscopic treatment for emphysema; case reports and non-English or non-Spanish studies were excluded.

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