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

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 basel... Mehr ...

Verfasser: van Dijk, Marlies
Klooster, Karin
Hartman, Jorine E.
ten Hacken, Nick H. T.
Slebos, Dirk-Jan
Dokumenttyp: Artikel
Erscheinungsdatum: 2020
Reihe/Periodikum: van Dijk , M , Klooster , K , Hartman , J E , ten Hacken , N H T & Slebos , D-J 2020 , ' Change in Dynamic Hyperinflation After Bronchoscopic Lung Volume Reduction in Patients with Emphysema ' , Lung , vol. 198 , no. 5 , pp. 795-801 . https://doi.org/10.1007/s00408-020-00382-x
Schlagwörter: Female / Humans / Lung/diagnostic imaging / Lung Volume Measurements/methods / Male / Middle Aged / Netherlands / Outcome Assessment / Health Care/methods / Pneumonectomy/adverse effects / Pulmonary Emphysema/diagnosis / Residual Volume / Respiratory Function Tests/methods / Severity of Illness Index / Tomography / X-Ray Computed/methods / Walk Test/methods
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-26825134
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/45fc111c-b982-4a75-aa9c-5fcbca35117d

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 < 0.01) vs 0 ml (- 1067 to + 500) in the control group (p = 0.422). An increase in dynamic hyperinflation was significantly associated with a decrease in residual volume (r = - 0.439, p < 0.01). 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.