Update on Nonsurgical Lung Volume Reduction Procedures
There has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory m...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2016/6462352 |
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| author | J. Alberto Neder Denis E. O’Donnell |
| author_facet | J. Alberto Neder Denis E. O’Donnell |
| author_sort | J. Alberto Neder |
| collection | DOAJ |
| description | There has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC) < 25%, residual volume > 225% predicted) and thoracic hyperinflation (TLC > 150% predicted) have the greatest potential to derive benefit from ELVR procedures. Pre-LVRS or ELVR assessment should ideally include cardiological evaluation, high resolution CT scan, ventilation and perfusion scintigraphy, full pulmonary function tests, and cardiopulmonary exercise testing. ELVR procedures are currently available in selected Canadian research centers as part of ethically approved clinical trials. If a decision is made to offer an ELVR procedure, one-way valves are the first option in the presence of complete lobar exclusion and no significant collateral ventilation. When the fissure is not complete, when collateral ventilation is evident in heterogeneous emphysema or when emphysema is homogeneous, coil implants or BioLVR (in that order) are the next logical alternatives. |
| format | Article |
| id | doaj-art-86f69970df534ebe8d1999a14cae1b33 |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-86f69970df534ebe8d1999a14cae1b332025-02-03T00:58:54ZengWileyCanadian Respiratory Journal1198-22411916-72452016-01-01201610.1155/2016/64623526462352Update on Nonsurgical Lung Volume Reduction ProceduresJ. Alberto Neder0Denis E. O’Donnell1Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen’s University and Kingston General Hospital, Kingston, ON, K7L 2V6, CanadaDivision of Respiratory and Critical Care Medicine, Department of Medicine, Queen’s University and Kingston General Hospital, Kingston, ON, K7L 2V6, CanadaThere has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC) < 25%, residual volume > 225% predicted) and thoracic hyperinflation (TLC > 150% predicted) have the greatest potential to derive benefit from ELVR procedures. Pre-LVRS or ELVR assessment should ideally include cardiological evaluation, high resolution CT scan, ventilation and perfusion scintigraphy, full pulmonary function tests, and cardiopulmonary exercise testing. ELVR procedures are currently available in selected Canadian research centers as part of ethically approved clinical trials. If a decision is made to offer an ELVR procedure, one-way valves are the first option in the presence of complete lobar exclusion and no significant collateral ventilation. When the fissure is not complete, when collateral ventilation is evident in heterogeneous emphysema or when emphysema is homogeneous, coil implants or BioLVR (in that order) are the next logical alternatives.http://dx.doi.org/10.1155/2016/6462352 |
| spellingShingle | J. Alberto Neder Denis E. O’Donnell Update on Nonsurgical Lung Volume Reduction Procedures Canadian Respiratory Journal |
| title | Update on Nonsurgical Lung Volume Reduction Procedures |
| title_full | Update on Nonsurgical Lung Volume Reduction Procedures |
| title_fullStr | Update on Nonsurgical Lung Volume Reduction Procedures |
| title_full_unstemmed | Update on Nonsurgical Lung Volume Reduction Procedures |
| title_short | Update on Nonsurgical Lung Volume Reduction Procedures |
| title_sort | update on nonsurgical lung volume reduction procedures |
| url | http://dx.doi.org/10.1155/2016/6462352 |
| work_keys_str_mv | AT jalbertoneder updateonnonsurgicallungvolumereductionprocedures AT deniseodonnell updateonnonsurgicallungvolumereductionprocedures |