Endobronchial Valve Treatment in Emphysema Patients with a Very Low DLCO

van Dijk, M., Hartman, J. E., Klooster, K., Ten Hacken, N. H. T., Kerstjens, H. A. M. & Slebos, D-J., 21-Jan-2020, In : Respiration. 99, p. 163-170 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

BACKGROUND: For selected patients with severe emphysema, bronchoscopic lung volume reduction with endobronchial valves (EBV) is recognized as an additional treatment option. In most trials investigating EBV treatment, patients with a very low diffusing capacity (DLCO) were excluded from participation.

OBJECTIVES: Our goal was to investigate whether EBV treatment in patients with emphysema with a very low DLCO is safe and effective.

METHODS: This was a single-center retrospective analysis including patients with emphysema and a DLCO ≤20%pred who underwent EBV treatment. Follow-up was performed 6 months post-treatment. Outcome parameters were compared to a historical matched control group (DLCO >20%pred, matched for sex, age, forced expiratory volume in 1 s [FEV1], and residual volume [RV]).

RESULTS: Twenty patients (80% female, 64 ± 6 years, FEV1 26 ± 6%pred, RV 233 ± 45%pred, DLCO 18 ± 1.6%pred) underwent EBV treatment. At 6 months follow-up, we found a statistically significant improvement in FEV1 (0.08 ± 0.12 L), RV (-0.45 ± 0.95 L), 6-min walking distance (38 ± 65 m), and St. George's Respiratory Questionnaire (-12 ± 13 points). With the exception of FEV1, all exceeded the minimal clinically important difference. The most common serious adverse event was a pneumothorax requiring intervention (15%). There were no significant differences in outcome compared to the DLCO >20%pred control group.

CONCLUSIONS: In this single-center retrospective analysis, we showed statistically significant and clinically relevant improvements in lung function, exercise capacity, and quality of life up to 6 months after EBV treatment in emphysema patients with a DLCO ≤20% (14-20%) of predicted with no increased risk of serious adverse events.

Original languageEnglish
Pages (from-to)163-170
Number of pages8
Publication statusE-pub ahead of print - 21-Jan-2020

ID: 112668436