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Endoscopic lung volume reduction with one-way valves in patients with severe chronic obstructive pulmonary disease with hypercapnia

Background: Robust clinical evidence on the efficacy and safety of endoscopic lung volume reduction (ELVR) with one-way valves in patients with severe lung emphysema with chronic hypercapnic respiratory failure is lacking. Objective: The aim of this study was to compare patient characteristics, clin...

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Main Authors: Lenga, Pavlina (Author) , Grah, Christian (Author) , Ruwwe-Glösenkamp, Christoph (Author) , Saccomanno, Jacopo (Author) , Rückert, Jens (Author) , Eggeling, Stephan (Author) , Gläser, Sven (Author) , Kurz, Sylke (Author) , Eisenmann, Stephan (Author) , Krüger, Marcus (Author) , Schmidt, Bernd (Author) , Schneider, Paul (Author) , Andreas, Stefan (Author) , Hinterthaner, Marc (Author) , Pfannschmidt, Joachim (Author) , Gebhardt, Andreas (Author) , Stanzel, Franz (Author) , Holland, Angélique (Author) , Kirschbaum, Andreas (Author) , Becke, Birgit (Author) , Hübner, Ralf-Harto (Author)
Format: Article (Journal)
Language:English
Published: September 2022
In: Respiration
Year: 2022, Volume: 101, Issue: 9, Pages: 823-832
ISSN:1423-0356
DOI:10.1159/000524996
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000524996
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Author Notes:Pavlina Lenga, Christian Grah, Christoph Ruwwe-Glösenkamp, Jacopo Saccomanno, Jens Rückert, Stephan Eggeling, Sven Gläser, Sylke Kurz, Stephan Eisenmann, Marcus Krüger, Bernd Schmidt, Paul Schneider, Stefan Andreas, Marc Hinterthaner, Joachim Pfannschmidt, Andreas Gebhardt, Franz Stanzel, Angélique Holland, Andreas Kirschbaum, Birgit Becke, Ralf-Harto Hübner, on behalf of the Lung Emphysema Registry Study Group
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Summary:Background: Robust clinical evidence on the efficacy and safety of endoscopic lung volume reduction (ELVR) with one-way valves in patients with severe lung emphysema with chronic hypercapnic respiratory failure is lacking. Objective: The aim of this study was to compare patient characteristics, clinical outcome measures, and incidences of adverse events between patients with severe COPD undergoing ELVR with one-way valves and with either a partial pressure of carbon dioxide (pCO2) of ≤45 mm Hg or with pCO2 >45 mm Hg. Methods: This was a multicentre prospective study of patients with severe lung disease who were evaluated based on lung function, exercise capacity (6-min walk test [6-MWT]), and quality-of-life tests. Results: Patients with pCO2 ≤45 mm Hg (n = 157) and pCO2 >45 mm Hg (n = 40) showed similar baseline characteristics. Patients with pCO2 ≤45 mm Hg demonstrated a significant increase in forced expiratory volume in 1 s (p < 0.001), a significant decrease in residual volume (RV) (p < 0.001), and significant improvements in the quality of life and 6-MWT at the 3-month follow-up. Patients with pCO2 >45 mm Hg had significant improvements in RV only (p < 0.05). There was a significant decrease in pCO2 between baseline and follow-up in hypercapnic patients, relative to the decrease in patients with pCO2 ≤45 mm Hg (p = 0.008). Patients who were more hypercapnic at baseline showed a greater reduction in pCO2 after valve placement (r = −0.38, p < 0.001). Pneumothorax was the most common adverse event in both groups. Conclusions: ELVR with one-way valves seems clinically beneficial with a remarkably good safety profile for patients with chronic hypercapnic respiratory failure.
Item Description:Gesehen am 29.10.2025
Physical Description:Online Resource
ISSN:1423-0356
DOI:10.1159/000524996

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