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Assessment of lung functions using impulse oscillometry before and after bronchoscopic lung volume reduction with histoacryl gel

Abstract

Background

Many forms of bronchoscopic lung volume reduction were introduced as a treatment for patients with emphysema surpassing the surgical management and its fatality. Biological bronchoscopic lung volume reduction (BBLVR) proved to be a safe and competent solution inducing collapse of the emphysematous segment(s). Impulse oscillometry (IOS) constitutes an effortless but underused surrogate to spirometry in assessment of pulmonary function. Therefore, the aim of this study was to evaluate the use of IOS before and after BBLVR with histoacryl gel in comparison with spirometry among patients with emphysema.

Patients and methods

A prospective comparative follow-up study was performed at Kobry El-Kobba Military Hospital. A total of 30 patients with radiological evidence of heterogenous emphysema or emphysematous bullae were enrolled during the period from July 2014 to April 2015. BBLVR was accomplished by the instillation of the histoacryl gel into the affected segment(s) using standard technique. Clinical, radiological, and functional assessments were done before and 4 weeks after the procedure.

Results

After BBLVR, the following outcome was measured: 6-min walk test, partial pressure of O2 in arterial blood, forced expiratory volume in the first second, resistance at 5 Hz, resistance at 20 Hz, and reactance at 5 Hz. They improved with statistical significance among all the patients. There was a negative correlation between forced vital capacity and resistance at 5 Hz in the heterogenous emphysema group (ρ=0.47 and P<0.025); however, the forced expiratory volume at first second showed positive correlation with reactance at 5 Hz in emphysematous bullae group (ρ=0.82 and P<0.023).

Conclusion

BBLVR with histoacryl gel is associated with improvement in exercise capacity and lung functions. IOS provided comprehensive assessment of the pulmonary functions, which was in good correlation with spirometry.

References

  1. Shah PL, Hopkinson NS. Bronchoscopic lung volume reduction for emphysema: where next? Eur Respir J 2012; 39: 1287–1289.

    Article  Google Scholar 

  2. Cooper JD, Trulock EP, Triantafilou AN, Patterson GA, Pohl MS, Deloney PA, et al. Bilateral pneumectomy for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg 1995; 109: 106–119.

    Article  CAS  Google Scholar 

  3. Weinmann GG, Chiang YP, Sheingold S. The National Emphysema Treatment Trial (NETT). A Study in Agency Collaboration. Proc Am Thorac Soc 2008; 5: 381–384.

    Article  Google Scholar 

  4. Aldeyturriaga JF. Bronchoscopic lung volume reduction: 7 lessons learned. Arch Bronconeumol 2012; 48: 221–222.

    Google Scholar 

  5. Tidwel SL. Lung volume reduction for advanced emphysema: surgical and bronchoscopic approaches. South Med J 2012; 105: 56–61.

    Article  Google Scholar 

  6. Criner GJ, Pinto-Plata V, Strange C, Dransfield M, Gotfried M, Leeds W, et al. Biologic lung volume reduction in advanced upper lobe emphysema : phase 2 results. Am J Respir Crit Care Med 2009; 179: 791–798.

    Article  Google Scholar 

  7. Laprad AS, Lutchen KR. Respiratory impedance measurements for assessment of lung mechanics: focus on asthma. Respir Physiol Neurobio 2008; 163: 64–73.

    Article  Google Scholar 

  8. Bickel S, Popler J, Lesnick B, Eid N. Impulse oscillometry interpretation and practical applications. Chest 2014; 146: 841–847.

    Article  Google Scholar 

  9. Kanda S, Fujimoto K, Komatsu Y, Yasuo M, Hanaoka M, Kubo K. Evaluation of respiratory impedance in asthma and COPD by an impulse oscillation system. Intern Med 2010; 49: 23–30.

    Article  Google Scholar 

  10. Crisafulli E, Clini EM. Measures of dyspnea in pulmonary rehabilitation. Multidiscip Respir Med 2010; 5: 202–210.

    Article  Google Scholar 

  11. Carpo RO, Casaburi R, Coates AL, Enright PL, MacIntyre NR, McKay RT, et al. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care 2002; 166: 111–117.

    Article  Google Scholar 

  12. Moore VC. Spirometry: step by step. Breathe 2012; 8: 232–240.

    Article  Google Scholar 

  13. Oostveen E, MacLeod D, Lorino H, Farre R, Hantos Z, Desager K, Marchal F. ERS Task Force on Respiratory Impedance Measurements. The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J 2003; 22: 1026–1041.

    Article  CAS  Google Scholar 

  14. Ahmed MM, Farghaly A, Wgeh KM, Shehata HM. Bronchoscopic Lung volume reduction by histoacryl. Report on the first 40 patients. Available at: https://www.wabipacademy.com/publications/abstracts/wcbip/2016//119-abstractbook2016/file. [Accessed 24 August 2017].

  15. IBMSPSS.Statistics for Windows, version 22. Armonk, NY: IBM Corp.; 2013.

  16. Reilly R, Washko G, Pinto-Plata V, Velez E, Kenney L, Berger R, Celli B. Biological lung volume reduction: a new bronchoscopic therapy for advanced emphysema. Chest 2007; 131: 1108–1113.

    Article  Google Scholar 

  17. Ingenito EP, Wood DE, Utz JP. Bronchoscopic lung volume reduction in severe emphysema. Proc Am Thorac Soc 2008; 5: 454–460.

    Article  Google Scholar 

  18. Refaely Y, Dransfield M, Kramer MR, Gotfried M, Leeds W, Mclennan G, et al. Biologic lung volume reduction therapy for advanced homogeneous emphysema. Eur Respir J 2010; 36: 20–27.

    Article  CAS  Google Scholar 

  19. Fessler1 HE, Scharf SM, Ingenito EP, et al. Physiologic basis for improved pulmonary function after lung volume reduction. Proc Am Thorac Soc 2008; 5: 416–420.

    Article  Google Scholar 

  20. Hira HS, Munja J, Zachariah S, et al. The site of airway obstruction among patients of emphysema: role of impulse oscillometry. Lung India 2008; 25: 8–13.

    Article  Google Scholar 

  21. Tse HN, Tseng CS, Wong KY, et al. Accuracy of forced oscillation technique to assess lung function in geriatric COPD population. Int J Chron Obstruct Pulmon Dis 2016; 11: 1105–1118.

    Article  Google Scholar 

  22. Kolsum U, Borrill Z, Roy K, Starkey C, Vestbo J, Houghton C, Singh D. Impulse oscillometry in COPD: identification of measurements related to airway obstruction, airway conductance and lung volumes. Respir Med 2009; 103: 136–143.

    Article  Google Scholar 

  23. Fessler HE. Collateral damage assessment for endobronchial lung volume reduction. J Appl Physiol 2009; 106: 755–756.

    Article  Google Scholar 

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Correspondence to Nevine Abd Elfattah MBBS, MD.

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Khattab, A.M., Abd Elfattah, N., Farghaly, A. et al. Assessment of lung functions using impulse oscillometry before and after bronchoscopic lung volume reduction with histoacryl gel. Egypt J Bronchol 13, 43–48 (2019). https://doi.org/10.4103/ejb.ejb_79_17

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