BACKGROUND: Existing medical treatments have limitations in the management of very severe chronic obstructive pulmonary disease (COPD). METHODS: We performed bronchoscopic lung volume reduction (BLVR) using transbronchial infusion of autologous blood and thrombin (BLVR with blood) in three patients with very severe COPD whose dyspnea could not be relieved by maximum medical management. Two patients underwent BLVR with blood in the left and right lungs at intervals of a half-year or a year, and one patient underwent this procedure in only the right lung. We assessed the changes in pulmonary function, exercise capacity and quality of life before and after BLVR with blood in a total of five procedures. RESULTS: The subjects were 58- to 74-year-old males. Their forced expiratory volume in one second (FEV1) percent predicted ranged from 14.8% to 23.4%. BLVR with blood achieved significant improvements as follows (values before → after the procedure, mean ± standard deviation): FEV1 0.45r the L → 0.76r the L (P=0.004), inspiratory capacity 1.50cityo L → 2.05±.05c L (P=0.015), 3-minute walk test 46.8nuteo m → 89.6±34.5 m (P=0.004). Lung function peaked several months after BLVR with blood and returned to nearly the baseline level in 6 months, but exercise capacity was better than that at baseline for at least 12 months. St. George's Respiratory Questionnaire (SGRQ), measured in two patients before and 12 months after the procedure, showed remarkable improvements (-15.6 and -11.9 units). CONCLUSIONS: BLVR with blood is an effective palliative treatment for very severe COPD.
BACKGROUND: Existing medical treatments have limitations in the management of very severe chronic obstructive pulmonary disease (COPD). METHODS: We performed bronchoscopic lung volume reduction (BLVR) using transbronchial infusion of autologous blood and thrombin (BLVR with blood) in three patients with very severe COPD whose dyspnea could not be relieved by maximum medical management. Two patients underwent BLVR with blood in the left and right lungs at intervals of a half-year or a year, and one patient underwent this procedure in only the right lung. We assessed the changes in pulmonary function, exercise capacity and quality of life before and after BLVR with blood in a total of five procedures. RESULTS: The subjects were 58- to 74-year-old males. Their forced expiratory volume in one second (FEV1) percent predicted ranged from 14.8% to 23.4%. BLVR with blood achieved significant improvements as follows (values before → after the procedure, mean ± standard deviation): FEV1 0.45r the L → 0.76r the L (P=0.004), inspiratory capacity 1.50cityo L → 2.05±.05c L (P=0.015), 3-minute walk test 46.8nuteo m → 89.6±34.5 m (P=0.004). Lung function peaked several months after BLVR with blood and returned to nearly the baseline level in 6 months, but exercise capacity was better than that at baseline for at least 12 months. St. George's Respiratory Questionnaire (SGRQ), measured in two patients before and 12 months after the procedure, showed remarkable improvements (-15.6 and -11.9 units). CONCLUSIONS: BLVR with blood is an effective palliative treatment for very severe COPD.
Authors: D H Sterman; A C Mehta; D E Wood; P N Mathur; R J McKenna; D E Ost; J D Truwit; P Diaz; M M Wahidi; R Cerfolio; R Maxfield; A I Musani; T Gildea; F Sheski; M Machuzak; A R Haas; H X Gonzalez; S C Springmeyer Journal: Respiration Date: 2009-11-17 Impact factor: 3.580
Authors: Pallav L Shah; Zaid Zoumot; Suveer Singh; Stephen R Bicknell; Ewen T Ross; John Quiring; Nicholas S Hopkinson; Samuel V Kemp Journal: Lancet Respir Med Date: 2013-04-23 Impact factor: 30.700
Authors: Paulo F G Cardoso; Gregory I Snell; Peter Hopkins; Gerhard W Sybrecht; Georgios Stamatis; Alan W Ng; Philip Eng Journal: J Thorac Cardiovasc Surg Date: 2007-08-20 Impact factor: 5.209
Authors: Charlie Strange; Felix J F Herth; Kevin L Kovitz; Geoffrey McLennan; Armin Ernst; Jonathan Goldin; Marc Noppen; Gerard J Criner; Frank C Sciurba Journal: BMC Pulm Med Date: 2007-07-03 Impact factor: 3.317
Authors: Mostafa Bakeer; Taha Taha Abdelgawad; Raed El-Metwaly; Ahmed El-Morsi; Mohammad Khairy El-Badrawy; Solafa El-Sharawy Journal: Int J Chron Obstruct Pulmon Dis Date: 2016-08-03