PT  - JOURNAL ARTICLE
AU  - Marlies van Dijk
AU  - Karin Klooster
AU  - Nick H.T. Ten Hacken
AU  - Frank Sciurba
AU  - Huib. A.M. Kerstjens
AU  - Dirk-Jan Slebos
TI  - The effects of lung volume reduction treatment on diffusing capacity and gas exchange
AID  - 10.1183/16000617.0171-2019
DP  - 2020 Dec 31
TA  - European Respiratory Review
PG  - 190171
VI  - 29
IP  - 158
4099  - http://err.ersjournals.com/content/29/158/190171.short
4100  - http://err.ersjournals.com/content/29/158/190171.full
SO  - EUROPEAN RESPIRATORY REVIEW2020 Dec 31; 29
AB  - Lung volume reduction (LVR) treatment in patients with severe emphysema has been shown to have a positive effect on hyperinflation, expiratory flow, exercise capacity and quality of life. However, the effects on diffusing capacity of the lungs and gas exchange are less clear. In this review, the possible mechanisms by which LVR treatment can affect diffusing capacity of the lung for carbon monoxide (DLCO) and arterial gas parameters are discussed, the use of DLCO in LVR treatment is evaluated and other diagnostic techniques reflecting diffusing capacity and regional ventilation (V′)/perfusion (Q′) mismatch are considered.A systematic review of the literature was performed for studies reporting on DLCO and arterial blood gas parameters before and after LVR surgery or endoscopic LVR with endobronchial valves (EBV). DLCO after these LVR treatments improved (40 studies, n=1855) and the mean absolute change from baseline in % predicted DLCO was +5.7% (range −4.6% to +29%), with no real change in blood gas parameters. Improvement in V′ inhomogeneity and V′/Q′ mismatch are plausible explanations for the improvement in DLCO after LVR treatment.This review shows that lung volume reduction treatment can lead to a small increase in DLCO, but on average no important changes in gas exchange. Improvement in V′ inhomogeneity and V′/Q′ mismatch may be explanations for the improvement in DLCO. https://bit.ly/3fsDqf3