Endobronchial valves for emphysema
Increased work of breathing and cough, decreased air entry bilaterally with expiratory wheeze loudest over the right base. Known severe COPD on home oxygen, FEV1 0.75L (25% predicted), DLCO 55% predicted.
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The lungs are severely emphysematous but no consolidation or pleural collection is demonstrated. Right lower lobe endobronchial valves are noted. Bilateral lower zone atelectasis or scarring. Heart size and cardiomediastinal contours are normal.
Endobronchial valves reduce the flow of air into the treated lobe during inspiration whilst allowing secretions and air to be expelled from that region during expiration. Its intention is to cause localized atelectasis in the target lobe, matching the size of the lungs to the size of the thorax containing them, thereby causing improvement in lung function, exercise tolerance, dyspnea, and quality of life.
Acknowledgement: Dr Theodore Lau
- 1. Fessler HE, Scharf SM, Ingenito EP, McKenna RJ, Sharafkhaneh A. Physiologic basis for improved pulmonary function after lung volume reduction. (2008) Proceedings of the American Thoracic Society. 5 (4): 416-20. doi:10.1513/pats.200708-117ET - Pubmed
- 2. Criner GJ, Sue R, Wright S, Dransfield M, Rivas-Perez H, Wiese T, Sciurba FC, Shah PL, Wahidi MM, de Oliveira HG, Morrissey B, Cardoso PFG, Hays S, Majid A, Pastis N, Kopas L, Vollenweider M, McFadden PM, Machuzak M, Hsia DW, Sung A, Jarad N, Kornaszewska M, Hazelrigg S, Krishna G, Armstrong B, Shargill NS, Slebos DJ. A Multicenter RCT of Zephyr® Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE). (2018) American journal of respiratory and critical care medicine. doi:10.1164/rccm.201803-0590OC - Pubmed