
pmid: 32710165
pmc: PMC7502448
Abstract Background and Purpose In patients with severe emphysema, dynamic hyperinflation is superimposed on top of already existing static hyperinflation. Static hyperinflation reduces significantly after bronchoscopic lung volume reduction (BLVR). In this study, we investigated the effect of BLVR compared to standard of care (SoC) on dynamic hyperinflation. Methods Dynamic hyperinflation was induced by a manually paced tachypnea test (MPT) and was defined by change in inspiratory capacity (IC) measured before and after MPT. Static and dynamic hyperinflation measurements were performed both at baseline and 6 months after BLVR with endobronchial valves or coils (treatment group) or SoC (control group). Results Eighteen patients underwent BLVR (78% female, 57 (43–67) years, FEV1 25(18–37) %predicted, residual volume 231 (182–376) %predicted). Thirteen patients received SoC (100% female, 59 (44–74) years, FEV1 25 (19–37) %predicted, residual volume 225 (152–279) %predicted. The 6 months median change in dynamic hyperinflation in the treatment group was: + 225 ml (range − 113 to + 803) (p < 0.01) vs 0 ml (− 1067 to + 500) in the control group (p = 0.422). An increase in dynamic hyperinflation was significantly associated with a decrease in residual volume (r = − 0.439, p < 0.01). Conclusion Bronchoscopic lung volume reduction increases the ability for dynamic hyperinflation in patients with severe emphysema. We propose this is a consequence of improved static hyperinflation.
Male, Outcome Assessment, Health Care/methods, Bronchoscopic Lung Volume Reduction, Walk Test, Severity of Illness Index, Lung/diagnostic imaging, Respiratory Function Tests/methods, Outcome Assessment, Health Care, Humans, Pulmonary Emphysema/diagnosis, Pneumonectomy/adverse effects, Pneumonectomy, Tomography, Lung, Netherlands, Walk Test/methods, Middle Aged, Lung Volume Measurements/methods, X-Ray Computed/methods, Respiratory Function Tests, Residual Volume, Pulmonary Emphysema, Female, Lung Volume Measurements, Tomography, X-Ray Computed
Male, Outcome Assessment, Health Care/methods, Bronchoscopic Lung Volume Reduction, Walk Test, Severity of Illness Index, Lung/diagnostic imaging, Respiratory Function Tests/methods, Outcome Assessment, Health Care, Humans, Pulmonary Emphysema/diagnosis, Pneumonectomy/adverse effects, Pneumonectomy, Tomography, Lung, Netherlands, Walk Test/methods, Middle Aged, Lung Volume Measurements/methods, X-Ray Computed/methods, Respiratory Function Tests, Residual Volume, Pulmonary Emphysema, Female, Lung Volume Measurements, Tomography, X-Ray Computed
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