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Saccomanno J, Sgarbossa T, Pappe E, Kilic L, Biglari S, Shargill NS, Radhakrishnan S, Witzenrath M, Hübner RH. VT20 method for Chartis assessment of collateral ventilation with flexible bronchoscopy under procedural sedation. ERJ Open Res 2024; 10:00945-2023. [PMID: 38978543 PMCID: PMC11228596 DOI: 10.1183/23120541.00945-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/25/2024] [Indexed: 07/10/2024] Open
Abstract
VT20 is applicable for Chartis assessments with conscious sedation and spontaneous ventilation or high-frequency jet ventilation, and the cut-off of ≤6 mL remains the same to distinguish between CV- and CV+ phenotypes https://bit.ly/3HG9iMQ.
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Affiliation(s)
- Jacopo Saccomanno
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Sgarbossa
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Eva Pappe
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lara Kilic
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | | | | | - Martin Witzenrath
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ralf-Harto Hübner
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Koster TD, Shah PL, Valipour A, Criner GJ, Herth FJF, Sue R, Hogarth DK, Martin RT, Mahajan AK, Alalawi R, Kopas L, Cohen A, Wood DE, Kurman J, Shargill NS, Dransfield M, Slebos DJ, Perch M. Optimizing clinical outcomes for bronchoscopic lung volume reduction with Zephyr® valves. Respir Med 2024; 227:107639. [PMID: 38642906 DOI: 10.1016/j.rmed.2024.107639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024]
Abstract
Bronchoscopic lung volume reduction treatment with Zephyr one-way valves is an effective guideline-based treatment option for patients with severe emphysema and hyperinflation. However, in some cases the treatment response is less than anticipated or there might be a loss of initial treatment effect. Reasons for the lack of response can include incorrect assessment of collateral ventilation, improper valve placement, or patient related factors. Loss of initial benefit can be due to granulation tissue formation and subsequent valve dysfunction, or there may be side effects such as excessive coughing or infectious problems. Careful follow-up after treatment with valves is important and evaluation with a CT scan and/or bronchoscopy is helpful if there is no improvement after treatment or loss of initial benefit. This paper aims to describe the most important causes and provide a strategy of how to approach and manage these patients.
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Affiliation(s)
- T David Koster
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Pallav L Shah
- Royal Brompton Hospital, Department of Pulmonology, London, United Kingdom; National Heart & Lung Institute, Imperial College, London, United Kingdom
| | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Health Care Group, Vienna, Austria
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Felix J F Herth
- Department of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), University of Heidelberg, Heidelberg, Germany
| | - Richard Sue
- Advanced Lung Institute, Banner University Phoenix, Phoenix, AZ, USA
| | - Douglas K Hogarth
- Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, USA
| | - Ralitza T Martin
- Piedmont/MD Anderson Healthcare Network System, Houston, TX, USA
| | | | - Raed Alalawi
- Banner Health, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Lisa Kopas
- Houston Methodist Hospital, Weill Cornell Medical College, Houston, TX, USA
| | - Avi Cohen
- Henry Ford Health System, Detroit, MI, USA
| | - Douglas E Wood
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Jonathan Kurman
- Division of Pulmonary & Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Mark Dransfield
- Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dirk-Jan Slebos
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Michael Perch
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Section for Lung Transplantation and Respiratory Medicine, Herat Center, Rigshospitalet, Copenhagen, Denmark
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Omballi M, Noori Z, Alanis RV, Lukken Imel R, Kheir F. Chartis-guided Endobronchial Valves Placement for Persistent Air Leak. J Bronchology Interv Pulmonol 2023; 30:398-400. [PMID: 36877223 DOI: 10.1097/lbr.0000000000000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/07/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Mohamed Omballi
- Department of Pulmonary and Critical Care Medicine, University of Toledo, Toledo, OH
| | - Zaid Noori
- Department of Pulmonary and Critical Care Medicine, University of Toledo, Toledo, OH
| | - Regina V Alanis
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Robert Lukken Imel
- Department of Pulmonary and Critical Care Medicine, University of Toledo, Toledo, OH
| | - Fayez Kheir
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Koster TD, Dijk MV, Slebos DJ. Bronchoscopic Lung Volume Reduction for Emphysema: Review and Update. Semin Respir Crit Care Med 2022; 43:541-551. [PMID: 35562097 DOI: 10.1055/s-0042-1747938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In carefully selected patients with severe chronic obstructive pulmonary disease, characterized by emphysema and hyperinflation, lung volume reduction is an option to reduce lung hyperinflation, improve lung function, quality of life, and exercise capacity. Currently, there are several bronchoscopic and surgical treatment options to achieve lung volume reduction. It is important to carefully phenotype these patients, to select the optimal treatment option, with consideration of possible adverse events or contraindications, and it is highly recommended to discuss these treatment strategies in a multidisciplinary team. The treatment with one-way endobronchial valves has been investigated most extensively and more data are available regarding the treatment of more "marginal cases," or subsequent lung volume reduction surgery. Other bronchoscopic lung volume reduction options include treatment with coils, thermal vapor ablation, and sclerosant agents. In this review, we aim to summarize the current clinical evidence on the bronchoscopic lung volume reduction therapies and important aspects regarding optimal patient selection.
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Affiliation(s)
- T David Koster
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marlies Van Dijk
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Dirk-Jan Slebos
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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