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Bronchoscopic lung volume reduction

M. I. Polkey, N. S. Hopkinson
European Respiratory Review 2006 15: 99-103; DOI: 10.1183/09059180.00010009
M. I. Polkey
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N. S. Hopkinson
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Figures

  • FIGURE 1.
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    FIGURE 1.

    Emphasys (Emphasys Medical, Inc., Redwood City, CA, USA) endobronchial valves. a) Initial Emphasys endobronchial valve; b) modified Emphasys endobronchial valve, suitable for transcopic insertion.

  • FIGURE 2.
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    FIGURE 2.

    a) The Spiration (Spiration, Inc., Redmond, WA, USA) device. b) The device is arranged so that the convex surface is positioned distally, with the aim of allowing expiratory but not inspiratory flow.

  • FIGURE 3.
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    FIGURE 3.

    Computed tomography before (a and c) and after (b and d) placement of endobronchial valves to the right upper lobe. Post-procedure atelectasis is shown with movement of the fissure (–––––– on the coronal reconstruction). Image courtesy of T. Toma and D.A. Hansell (both at the Dept of Medicine and Radiology, Royal Brompton Hospital, London, UK).

  • FIGURE 4.
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    FIGURE 4.

    Individual data for inspiratory capacity at isotime in patients submitted to unilateral bronchoscopic lung volume reduction. A mean increase is observed (i.e. a fall in end-expiratory lung volume). However, mean improvement includes some patients with reduced dynamic hyperinflation (DH) after the procedure and some with increased DH. ▵: patients who developed atelectasis (with the exception of one patient, who developed a pneumothorax, these patients invariably improved); •: patients who did not develop atelectasis. Taken from [14].

  • FIGURE 5.
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    FIGURE 5.

    Neuromechanical coupling was measured in a subset of patients and expressed as tidal volume (VT) divided by the amplitude of the inspiratory pressure swing (PI,swing) during exercise. Improvement at isotime strongly correlated with reduction in dynamic hyperinflation. ΔEELV: change in end-expiratory lung volume. Taken from [14].

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Bronchoscopic lung volume reduction
M. I. Polkey, N. S. Hopkinson
European Respiratory Review Dec 2006, 15 (100) 99-103; DOI: 10.1183/09059180.00010009

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Bronchoscopic lung volume reduction
M. I. Polkey, N. S. Hopkinson
European Respiratory Review Dec 2006, 15 (100) 99-103; DOI: 10.1183/09059180.00010009
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  • Article
    • Abstract
    • DATA CONCERNING HYPERINFLATION AND ENDOBRONCHIAL LUNG VOLUME REDUCTION
    • EXPERIENCE WITH ENDOBRONCHIAL THERAPY
    • FUTURE DIRECTIONS
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