Medical lung volume reduction for severe emphysema: A review

Lung hyperinflation is the main pathophysiological mechanism significantly reducing the Quality of Life (QoL)and contributing to increased morbidity and mortality of the emphysematous patients. Therefore, the prime aim of the management of those patients is the deflation of their lungs. There are a number of treatments proven effective to reduce hyperinflation, such as,pharmacotherapy (bronchodilators/deflators), rehabilitation and surgical volume reduction. Recently, methods to reduce lung volume by a bronchoscopic approach had been developed. We review these methods and in particular the endobronchial valves, coils and the sclerosing therapies and provide the current status, as well as, an algorithm of selection of the appropriate patients. We conclude that further large studies are needed in order to verify the effectiveness of these methods and identify the appropriate group of patients that can be benefit by each of these bronchoscopic techniques.