Document Detail


Biological lung volume reduction: a new bronchoscopic therapy for advanced emphysema.
MedLine Citation:
PMID:  17426216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Biological lung volume reduction (BLVR) using biological reagents to remodel and shrink damaged regions of lung has previously been accomplished in sheep with experimental pulmonary emphysema. This report summarizes the initial clinical experience including a 3-month follow-up using this technique in humans. METHODS: An open-label phase 1 trial designed to evaluate the safety of BLVR in patients with advanced heterogeneous emphysema enrolled six patients. Of these, three patients received unilateral treatment at two pulmonary subsegments (group 1) and three patients received unilateral treatment at four pulmonary subsegments (group 2). The incidence of adverse events and changes in pulmonary function test results, symptoms, and exercise capacity were evaluated. RESULTS: The mean (+/- SD) age of the six men enrolled in the study was 66 +/- 5.7 years (age range, 57 to 73 years). BLVR was well tolerated in both treatment groups and was not associated with any serious complications. All patients were discharged from the hospital on posttreatment day 1. Although the primary purpose of the study was to examine safety, improvements were observed in mean vital capacity (+7.2 +/- 9.5%; range, -2% to + 19%), mean residual volume (RV) [-7.8 +/- 8.5%; range, + 1% to -22%], mean RV/total lung capacity ratio (-6.6 +/- 4.7%; range, -1% to -15%), mean 6-min walk distance (+14.5 +/- 18.5%; range, 0 to + 51%), and in mean dyspnea score. On average, group 2 patients experienced greater benefit from BLVR than group 1 patients, suggesting a dose-response pattern. CONCLUSIONS: Preliminary results indicate that BLVR can be safe and may produce benefits in appropriately selected patients with advanced heterogeneous emphysema.
Authors:
John Reilly; George Washko; Victor Pinto-Plata; Eduardo Velez; Lawrence Kenney; Robert Berger; Bartolome Celli
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Publication Detail:
Type:  Clinical Trial, Phase I; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  131     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-11     Completed Date:  2007-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1108-13     Citation Subset:  AIM; IM    
Affiliation:
Brigham and Women's Hospital, Pulmonary/Critical Care Medicine, 75 Francis St, Boston, MA 02115-6110, USA. jreilly@partners.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Bronchoscopy*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pneumonectomy / methods*
Pulmonary Emphysema / physiopathology,  radiography,  surgery*
Residual Volume
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Vital Capacity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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