Bronchoscopic treatment options for chronic obstructive pulmonary disease

Year 2016, Special Issue: 3 Pulmonary and Critical Care Medicine, 16 - 20, 27.11.2016

Şehnaz Olgun Yıldızeli

https://doi.org/10.5472/MMJsi.2902.04

Abstract

Chronic obstructive pulmonary disease (COPD) is a major cause

of high mortality and morbidity worldwide. Symptoms of the

disease are usually related with the results of pulmonary dynamic

hyperinflation. Treatment options are classified as invasivenoninvasive

and mostly tend to be palliative. Lung volume

reduction techniques are invasive part of the treatment and can

be performed by surgical or bronchoscophic methods. Because

of the low complication rates bronchoscophic methods became

more popular in recent years. Patients presenting with severe air

trapping and thoracic hyperinflation have the greatest potential

to derive benefit from volume reduction procedures. Assessment

of patients should ideally include cardiological evaluation, high

resolution CT scan, ventilation and perfusion scintigraphy, full

pulmonary function tests, and cardiopulmonary exercise testing.

There are three main groups of bronchoscophic volume

reduction, direct effect on lung parenchyma, airway bypass

and blocking the airways. Indications and contraindications

are different for each modality and device. Patients who have

deterioration despite habitual changes and medical therapies

should be evaluated for volume reduction procedures.

Keywords

COPD, Emphysema, Hyperinflation, Lung volume reduction, Bronchoscopic

References

• Murray CJ, Lopez AD. Measuring the global burden of disease. N Engl J Med 2013;369:448-57.
• Lopez AD, Murray CC. The global burden of disease, 1990-2020. Nat Med 1998;4:1241-3.