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Bronchoscopic Lung Volume Reduction For Pulmonary Emphysema: Preliminary Experience With Endobronchial Occluder.
MedLine Citation:
PMID:  23345470     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose:This article describes the Self-Expanding Endobronchial Occluder (SEEO) as utilized in Bronchoscopic Lung Volume Reduction (BLVR) with a 36 month follow-up procedure.Methods:23 Patients with severe emphysema were recruited and underwent flexible bronchoscopic placement of the SEEOs. Outcomes were assessed at 1 week, 1-month, 3-, 6-, 12-, 24- and 36-month intervals including the feasibility, safety and efficacy which contained pulmonary function testing, 6-minute walking distance (6MWD) test, dyspnea grade assessment, BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index and St. George Respiratory Questionnaire (SGRQ).Results:58 SEEOs were implanted into 23 lobes previously selected. No displacement was found during the follow-up. 5 patients experienced post-operative complications of cough and 6 patients were subjected to lobar pneumonia, which were not located in any of the blocked segments. The FEV(1) in 18 patients were improved by more than 15% compared with baselines (P<0.001), and the mean first efficacy time and maximal efficacy time were 5.65±1.51 months and 6.35±3.08 months, respectively. The mean baseline DLCO significantly increased over a 12-month period (P<0.05). No significant changes were observed in FVC and RV/TLC. 6MWD test, dyspnea grades and SGRQ total scores were improved in 22 patients over a 24-month periods with a minority of patients continuing to improve until the end of the study. Mean baseline BODE index was improved during follow-up but not at the study's conclusion.Conclusions:The preliminary study demonstrates early significant improvements in pulmonary function, 6MWD test, dyspnea grades, BODE index, Quality-of-life, and ease of placement and acceptable safety post BLVR with SEEOs. But the initial improvements were only maintained long term for a minority of patients.
Authors:
Liqiang Song; Feng Zhao; Xinyu Ti; Weiqiang Chen; Gaowen Wang; Changgui Wu; Yan Li
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-23
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Respiratory Medicine and Center of Intensive Care Unit and.
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