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Article

Early Spirometry Following Bronchoscopic Lung Volume Reduction with Endobronchial Valves

1
Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
2
Department of Pulmonology, Hirslanden Clinic St. Anna, St. Anna-Strasse 32, 6006 Luzern, Switzerland
*
Author to whom correspondence should be addressed.
These authors contributed equally to this article.
Academic Editors: Lutz Freitag and Gregor S. Zimmermann
J. Clin. Med. 2022, 11(2), 440; https://doi.org/10.3390/jcm11020440
Received: 14 November 2021 / Revised: 5 January 2022 / Accepted: 12 January 2022 / Published: 15 January 2022
(This article belongs to the Special Issue Interventional Pulmonology: A New World)
Bronchoscopic lung volume reduction (BLVR) by endobronchial valve (EBV) implantation has been shown to improve dyspnea, pulmonary function, exercise capacity, and quality of life in highly selected patients with severe emphysema and hyperinflation. The most frequent adverse event is a pneumothorax (PTX), occurring in approximately one-fifth of the cases due to intrathoracic volume shifts. The majority of these incidents are observed within 48 h post-procedure. However, the delayed occurrence of PTX after hospital discharge is a matter of concern. There is currently no approved concept for its prevention. Particularly, it is unknown whether and when respiratory manoeuvers such as spirometry post EBV treatment are feasible and safe. As per standard operating procedure at the University Hospital Zurich, early spirometry is scheduled after BLVR and prior to the discharge of the patient in order to monitor treatment success. The aim of our retrospective study was to investigate the feasibility and safety of early spirometry. In addition, we hypothesized that early spirometry could be useful to identify patients at risk for late PTX, which may occur after hospital discharge. All patients who underwent BLVR using EBVs between January 2018 and January 2020 at our hospital were enrolled in this study. After excluding 16 patients diagnosed post-procedure with PTX and four patients for other reasons, early spirometry was performed in 61 cases. There was neither a clinically relevant PTX during or after early spirometry nor a late PTX following hospital discharge. In conclusion, we found early spirometry, conducted not sooner than three days following EBV treatment, to be feasible and safe. Furthermore, early spirometry seems to be a useful predictor for successful BLVR, and it may help to decide whether a patient can be discharged. Given the small sample size and the retrospective design of our study, a prospective study that includes routine chest imaging after early spirometry to definitively exclude PTX is needed to recommend early spirometry as part of the standard protocol following EBV treatment. View Full-Text
Keywords: spirometry; pneumothorax; bronchoscopic lung volume reduction; endobronchial valves; emphysema spirometry; pneumothorax; bronchoscopic lung volume reduction; endobronchial valves; emphysema
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MDPI and ACS Style

Bezel, P.; Wani, J.; Wiederkehr, G.; Bodmer, C.; Steinack, C.; Franzen, D.P. Early Spirometry Following Bronchoscopic Lung Volume Reduction with Endobronchial Valves. J. Clin. Med. 2022, 11, 440. https://doi.org/10.3390/jcm11020440

AMA Style

Bezel P, Wani J, Wiederkehr G, Bodmer C, Steinack C, Franzen DP. Early Spirometry Following Bronchoscopic Lung Volume Reduction with Endobronchial Valves. Journal of Clinical Medicine. 2022; 11(2):440. https://doi.org/10.3390/jcm11020440

Chicago/Turabian Style

Bezel, Pascal, Jasmin Wani, Gilles Wiederkehr, Christa Bodmer, Carolin Steinack, and Daniel P. Franzen. 2022. "Early Spirometry Following Bronchoscopic Lung Volume Reduction with Endobronchial Valves" Journal of Clinical Medicine 11, no. 2: 440. https://doi.org/10.3390/jcm11020440

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