Document Detail


Effect of unilateral endobronchial valve insertion on pulmonary ventilation and perfusion: a pilot study.
MedLine Citation:
PMID:  20636308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: The effects of bronchoscopic lung volume reduction (BLVR) on pulmonary ventilation and perfusion are incompletely understood. In this pilot trial, we investigated serial changes in regional ventilation and perfusion following unilateral endobronchial valve placement in COPD patients with heterogeneous emphysema.
METHODS: At baseline and at days 30 and 90 following BLVR, subjects underwent lung function, 6MWD and St George's Respiratory Questionnaire. Ventilation and perfusion scintigraphy were performed to quantitate and serially compare regional differences.
RESULTS: Six out of eight subjects completed the study; all had endobronchial valves targeting their left upper lobe. At day 90 post-BLVR, there was a trend towards an increase in FEV(1) and a mean reduction in St George's Respiratory Questionnaire score of nine units. In the targeted left upper zone there was reduced ventilation and perfusion. Ventilation and perfusion to the right lung; and specifically the right lower zone, significantly increased.
CONCLUSIONS: There appears to be redistribution of ventilation and perfusion to the contralateral lung following endobronchial valve placement. This may be of importance when assessing patients for unilateral BLVR. Selecting patients with heterogeneous disease is emphasized, taking into consideration not just comparison between upper and lower lobes, but between left and right lungs. A larger trial is currently underway, guided by these findings.
Authors:
Steven C S Chung; Matthew J Peters; Stephanie Chen; Louise Emmett; Alvin J Ing
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-07-15
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  15     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1079-83     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Respirology © 2010 Asian Pacific Society of Respirology.
Affiliation:
Department of Thoracic Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia. stev78@optusnet.com.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Humans
Lung / blood supply*,  physiopathology,  radiography
Male
Middle Aged
Pilot Projects
Pneumonectomy / instrumentation*,  methods
Pulmonary Disease, Chronic Obstructive / physiopathology,  surgery*
Pulmonary Emphysema / physiopathology,  surgery*
Pulmonary Ventilation*
Treatment Outcome

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


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