In:
Respiration, S. Karger AG, Vol. 101, No. 9 ( 2022), p. 823-832
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Robust clinical evidence on the efficacy and safety of endoscopic lung volume reduction (ELVR) with one-way valves in patients with severe lung emphysema with chronic hypercapnic respiratory failure is lacking. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 The aim of this study was to compare patient characteristics, clinical outcome measures, and incidences of adverse events between patients with severe COPD undergoing ELVR with one-way valves and with either a partial pressure of carbon dioxide (pCO 〈 sub 〉 2 〈 /sub 〉 ) of ≤45 mm Hg or with pCO 〈 sub 〉 2 〈 /sub 〉 & #x3e;45 mm Hg. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This was a multicentre prospective study of patients with severe lung disease who were evaluated based on lung function, exercise capacity (6-min walk test [6-MWT]), and quality-of-life tests. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Patients with pCO 〈 sub 〉 2 〈 /sub 〉 ≤45 mm Hg ( 〈 i 〉 n 〈 /i 〉 = 157) and pCO 〈 sub 〉 2 〈 /sub 〉 & #x3e;45 mm Hg ( 〈 i 〉 n 〈 /i 〉 = 40) showed similar baseline characteristics. Patients with pCO 〈 sub 〉 2 〈 /sub 〉 ≤45 mm Hg demonstrated a significant increase in forced expiratory volume in 1 s ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), a significant decrease in residual volume (RV) ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), and significant improvements in the quality of life and 6-MWT at the 3-month follow-up. Patients with pCO 〈 sub 〉 2 〈 /sub 〉 & #x3e;45 mm Hg had significant improvements in RV only ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.05). There was a significant decrease in pCO 〈 sub 〉 2 〈 /sub 〉 between baseline and follow-up in hypercapnic patients, relative to the decrease in patients with pCO 〈 sub 〉 2 〈 /sub 〉 ≤45 mm Hg ( 〈 i 〉 p 〈 /i 〉 = 0.008). Patients who were more hypercapnic at baseline showed a greater reduction in pCO 〈 sub 〉 2 〈 /sub 〉 after valve placement ( 〈 i 〉 r 〈 /i 〉 = −0.38, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Pneumothorax was the most common adverse event in both groups. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 ELVR with one-way valves seems clinically beneficial with a remarkably good safety profile for patients with chronic hypercapnic respiratory failure.
Type of Medium:
Online Resource
ISSN:
0025-7931
,
1423-0356
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
1464419-8
