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2018 ; 12
(ä): 1753466618760133
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Endoscopic lung volume reduction coil treatment in patients with very low FEV(1):
an observational study
#MMPMID29480070
Simon M
; Harbaum L
; Oqueka T
; Kluge S
; Klose H
Ther Adv Respir Dis
2018[Jan]; 12
(ä): 1753466618760133
PMID29480070
show ga
BACKGROUND: Endoscopic lung volume reduction coil (LVRC) treatment is a
therapeutic option for selected patients with advanced emphysema. The effects and
the safety of endoscopic lung volume reduction in patients with very low forced
expired volume in one second (FEV(1)) remain to be determined. This study was
conducted to assess the effects and the safety of LVRC treatment in patients with
very low FEV(1). METHODS: The study was performed as a retrospective
observational study in the Department of Respiratory Medicine at the University
Medical Center Hamburg-Eppendorf on patients with very low FEV(1), defined as an
FEV(1) ? 20% of predicted at baseline in whom LVRC treatment was performed
between 1?April 2012 and 28 February 2017. RESULTS: LVRC treatment was performed
in 33 patients with very low FEV(1). Of these, 45.5% were female and 54.5% were
male. At baseline, mean FEV(1) was 0.46 ± 0.12 liters (15 ± 3% of predicted),
mean forced vital capacity (FVC) was 1.61 ± 0.62 liters (42 ± 13% of predicted),
mean residual volume (RV) was 6.03 ± 0.81 liters (275 ± 51% of predicted) and
6-minute walk distance was 229 ± 102 m. Bilateral LVRC treatment was completed in
21 of these patients (63.6%). Bilateral LVRC treatment led to significant
improvements in functional parameters with an increase in mean FEV(1) from 0.44 ±
0.11 liters to 0.54 ± 0.12 liters ( p = 0.001), equivalent to a relative
improvement of 24.5 ± 26.9%, an increase in mean FVC from 1.49 ± 0.54 liters to
1.84 ± 0.49 liters ( p = 0.001), a decrease in mean RV from 6.27 ± 0.83 liters to
5.83 ± 1.09 liters ( p = 0.004) and an improvement in 6-minute walk distance from
218 ± 91 m to 266 ± 96 m ( p = 0.01). There were no cases of respiratory failure
requiring mechanical ventilation and no deaths. CONCLUSIONS: LVRC treatment was
effective and safe in patients with very low FEV(1).