Effects of Bronchoscopic Lung Volume Reduction Coil Treatment on Arterial Blood Gases

J Bronchology Interv Pulmonol. 2019 Apr;26(2):90-95. doi: 10.1097/LBR.0000000000000529.

Abstract

Background: Bronchoscopic lung volume reduction (BLVR) coil treatment is an increasingly used treatment modality for selected severe emphysema patients in recent years. Emphysema causes dynamic hyperinflation, loss of elastic recoil, air trapping, and decreased exercise capacity in advanced stages. This process progresses over time, leading to hypoxic and hypercapnic respiratory failure. The goal of this study is to elucidate the effects of BLVR coil treatment on arterial blood gas parameters in severe emphysema patients with respiratory failure.

Methods: This is a retrospective study performed at a single pneumology center in Turkey. In total, this study included 39 patients diagnosed with severe emphysema who underwent bilateral BLVR coil treatment according to the general inclusion and exclusion criteria in the literature. The patients baseline and 12-month data were collected from medical records.

Results: Twelve months after BLVR coil treatment, significant improvements were observed in patients' pulmonary function tests, an increase in partial pressure of oxygen in arterial blood (PaO2) from 58.05±9.36 to 73.82±13.3 (P<0.000) and decrease in partial pressure of carbon dioxide in arterial blood (PaCO2) of hypercapnic patients (from 51.60±4.1 to 46.55±6.6 mm Hg; P=0.001).

Conclusion: BLVR coil treatment is reliable and effective in emphysema patients who have hypoxic or mild hypercapnic respiratory failure. Besides improving lung function, BLVR coil treatment can significantly increase PaO2 and decrease PaCO2 in the medium term.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Gas Analysis
  • Bronchoscopy / methods*
  • Carbon Dioxide / blood
  • Female
  • Humans
  • Hypercapnia / blood
  • Hypercapnia / etiology
  • Hypoxia / blood
  • Hypoxia / etiology
  • Male
  • Middle Aged
  • Oxygen / blood
  • Partial Pressure
  • Pneumonectomy / methods*
  • Pulmonary Emphysema / blood
  • Pulmonary Emphysema / complications
  • Pulmonary Emphysema / surgery*
  • Respiratory Insufficiency / blood
  • Respiratory Insufficiency / etiology
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Turkey

Substances

  • Carbon Dioxide
  • Oxygen