Interventional Pulmonology

Roetting M.a,b· Kriegsmann K.c· Polke M.a· Polke N.a· Kontogianni K.a,d· Eberhardt R.d,e· Herth F.J.F.a,d· Gompelmann D.a,f

Author affiliations

aPneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
bDepartment of Internal Medicine V, Campus Fulda, University Medicine Marburg, Fulda, Germany
cDepartment of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
dTranslational Lung Research Center Heidelberg (TLRCH), German Center for Lung Research (DZL), Heidelberg, Germany
ePneumology & Intern. Intensive Care Medicine, AK Barmbek Hamburg, Hamburg, Germany
fDepartment of Internal Medicine II, Division of Pulmonology, Medical University of Vienna, Vienna, Austria

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Article / Publication Details

First-Page Preview

Received: June 26, 2021
Accepted: May 05, 2022
Published online: August 23, 2022

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Background: Endoscopic valve therapy has been established as a therapeutic option for patients with severe emphysema. Several randomized controlled trials confirmed the efficacy of this therapeutic approach in COPD patients without significant collateral ventilation. However, patients with clinical relevant hypercapnia were excluded from these trials. Aims and Objectives: Patients with hypercapnia who underwent endoscopic valve treatment were enrolled in this retrospective analysis. The efficacy of valve treatment and its impact on blood gases were analysed. Methods: COPD patients with mild to severe hypercapnia (pCO2 ≥45 mm Hg) who were treated by endoscopic valve placement at the Thoraxklinik, University of Heidelberg, were enrolled in this retrospective trial. Lung function test (vital capacity [VC], forced expiratory volume in 1 s [FEV1], residual volume [RV]), blood gases (pO2, pCO2), and 6-minute-walk test (6-MWT) were assessed prior to intervention and at 3 and 6 months following valve implantation. Results: 129 patients (mean age 64 ± 7 years) with severe COPD (mean FEV1 26 ± 12% of predicted, mean RV 285 ± 22% of predicted) with hypercapnia (pCO2 ≥45 mm Hg, mean pCO2 50 ± 5 mm Hg) underwent endoscopic valve treatment. 3 and 6 months following intervention, statistical significant improvement was observed in VC, FEV1, RV, and 6-MWT (all p < 0.001). Blood gas analysis revealed a significant improvement of mean pCO2 at 3- and 6-month follow-up (both p < 0.001). 40% of the patients had normal pCO2 values 3 and 6 months following intervention. Conclusion: COPD patients with hypercapnia should not be excluded from valve treatment, as the hyperinflation reduction improves the respiratory mechanics and thus leading to improvement of hypercapnia.

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First-Page Preview

Received: June 26, 2021
Accepted: May 05, 2022
Published online: August 23, 2022

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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