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Intrabullous blood injection for lung volume reduction.

S Kanoh¹, H Kobayashi, K Motoyoshi

¹Division of Pulmonary Medicine, Department of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. kanoh@ndmc.ac.jp

|May 31, 2008

Summary

Autologous blood injection is a new bronchoscopic treatment for emphysematous lung diseases. This less invasive method effectively reduced large lung bullae and improved patient dyspnea.

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Area of Science:

Pulmonology
Interventional Bronchoscopy
Thoracic Surgery

Background:

Emphysematous lung diseases, characterized by lung tissue destruction and air trapping, significantly impact patient quality of life.
Surgical interventions for severe emphysema, such as lung volume reduction surgery, carry substantial risks.
Minimally invasive bronchoscopic techniques are being explored as alternatives to surgery for emphysema management.

Observation:

A 59-year-old male presented with exertional dyspnea due to a large (12 cm) emphysematous bulla in the right upper lobe.
Computed tomography (CT) confirmed significant emphysema and bulla formation.
Bronchoscopic intervention was chosen as a less invasive alternative to surgical resection.

Findings:

Autologous blood and fibrinogen solution were infused into the bulla using a transbronchial catheter under fluoroscopic guidance.

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Post-procedure CT revealed marked bulla contraction, reducing its diameter to 3 cm.

This resulted in an estimated lung volume reduction of 800 ml, confirmed by body plethysmography.

Implications:

Autologous blood injection demonstrates potential as an effective, minimally invasive treatment for large emphysematous bullae.
This technique offers a promising alternative to surgery for lung volume reduction in select emphysema patients.
Further research is warranted to establish the long-term efficacy and safety of this bronchoscopic intervention.