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Atelectasis and survival after bronchoscopic lung volume reduction for COPD
N S Hopkinson1, S V Kemp, T P Toma
1NIHR Respiratory Disease Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital Campus, London, SW3 6NP, UK. n.hopkinson@ic.ac.uk
The European Respiratory Journal
|October 16, 2010
Summary
Bronchoscopic lung volume reduction (BLVR) can improve outcomes for emphysema patients. Notably, the occurrence of lobar atelectasis after BLVR was linked to a significant survival benefit in this patient group.
Area of Science:
- Pulmonary Medicine
- Interventional Pulmonology
- Thoracic Surgery
Background:
- Chronic obstructive pulmonary disease (COPD) management includes lung volume reduction strategies.
- Bronchoscopic lung volume reduction (BLVR) offers an alternative to lung volume reduction surgery (LVRS), particularly for patients unsuitable for surgery.
- Endobronchial valves are used in BLVR to achieve unilateral lobar occlusion in emphysema patients.
Purpose of the Study:
- To evaluate the long-term outcomes of bronchoscopic lung volume reduction (BLVR).
- To investigate the association between radiological atelectasis and survival following BLVR.
- To compare baseline characteristics between patients who developed atelectasis and those who did not.
Main Methods:
- Retrospective analysis of 19 patients who underwent BLVR between July 2002 and February 2004.
- Assessment of radiological atelectasis post-procedure.
- Long-term survival data collected up to February 2010.
- Comparison of baseline lung function, quality of life, exacerbation rates, exercise capacity, and CT findings.
Main Results:
- Radiological atelectasis occurred in five patients.
- None of the patients with atelectasis died during the follow-up period.
- Eight out of 14 patients without atelectasis died (p=0.026).
- No significant baseline differences were observed in lung function, quality of life, exacerbation rate, or exercise capacity between groups.
- Patients who developed atelectasis had a significantly higher body mass index.
Conclusions:
- Atelectasis following BLVR in emphysema patients is associated with a significant survival advantage.
- This survival benefit appears independent of baseline patient characteristics.
- BLVR with endobronchial valves is a viable option for emphysema, with atelectasis potentially indicating a favorable long-term prognosis.
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