Predictors of clinical outcome in emphysema patients with atelectasis following endoscopic valve therapy: A retrospective study

Background and objective The aim of endoscopic valve therapy in patients with emphysema is complete lobar atelectasis of the most emphysematous lobe. However, even after the radiological advent of atelectasis, great variability in clinical outcomes can be observed. Methods The baseline clinical meas...

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Bibliographic Details
Published in:Respirology (Carlton, Vic.) Vic.), 2016-10, Vol.21 (7), p.1255-1261
Main Authors: Gompelmann, Daniela, Hofbauer, Tobias, Gerovasili, Vasiliki, Eberhardt, Ralf, Lim, Hyun-ju, Herth, Felix, Heussel, Claus-Peter
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
atelectasis
computed tomography analysis
emphysema
Endoscopic lung volume reduction
Endoscopy - adverse effects
Female
Humans
Lung Volume Measurements
Male
Middle Aged
Pneumonectomy - adverse effects
Postoperative Complications - diagnostic imaging
Postoperative Complications - etiology
Pulmonary Atelectasis - diagnostic imaging
Pulmonary Atelectasis - etiology
Pulmonary Emphysema - diagnostic imaging
Pulmonary Emphysema - physiopathology
Pulmonary Emphysema - surgery
Residual Volume
Retrospective Studies
Risk Factors
Tidal Volume
Tomography, X-Ray Computed
Treatment Outcome
valve therapy
Vital Capacity
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Summary:Background and objective The aim of endoscopic valve therapy in patients with emphysema is complete lobar atelectasis of the most emphysematous lobe. However, even after the radiological advent of atelectasis, great variability in clinical outcomes can be observed. Methods The baseline clinical measures (vital capacity (VC), forced expiratory flow in 1 s (FEV1), residual volume (RV) and 6‐min walk test (6‐MWT)) and computed tomography variables (low attenuation volume (LAV) of the target lobe, LAV% of the target and the ipsilateral untreated lobe and LAV of the target lobe to LAV of the target lung and to LAV of the total lung) of 77 patients with complete atelectasis following valve therapy were retrospectively examined to determine their impact on patient´s outcome (changes in VC, FEV1, RV and 6‐MWT from baseline to the time of atelectasis). Results Low attenuation volume of the target lobe to LAV of the target lung predicts a significant FEV1 improvement in patients with complete lobar atelectasis following valve therapy. A 10% difference in that computed tomography predictor was associated with a 82‐mL improvement in FEV1 (P = 0.006). Lower 6‐MWT scores, low VC and high RV at baseline were significantly associated with greater improvement in the respective parameter (all P 
ISSN:1323-7799
1440-1843
DOI:10.1111/resp.12819