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Verfasst von:Gompelmann, Daniela [VerfasserIn]   i
 Herth, Felix [VerfasserIn]   i
Titel:Bronchoscopic thermal vapor ablation
Titelzusatz:best practice recommendations from an expert panel on endoscopic lung volume reduction
Verf.angabe:Daniela Gompelmann, Pallav L. Shah, Arschang Valipour, Felix J.F. Herth
E-Jahr:2018
Jahr:June 12, 2018
Umfang:9 S.
Teil:volume:95
 year:2018
 pages:392-400
 extent:9
Fussnoten:Gesehen am 13.05.2019
Titel Quelle:Enthalten in: Respiration
Ort Quelle:Basel : Karger, 1944
Jahr Quelle:2018
Band/Heft Quelle:95(2018), Seite 392-400
ISSN Quelle:1423-0356
Abstract:Bronchoscopic thermal vapor ablation (BTVA) represents one of the endoscopic lung volume reduction (ELVR) techniques that aims at hyperinflation reduction in patients with advanced emphysema to improve respiratory mechanics. By targeted segmental vapor ablation, an inflammatory response leads to tissue and volume reduction of the most diseased emphysematous segments. So far, BTVA has been demonstrated in several single-arm trials and 1 multinational randomized controlled trial to improve lung function, exercise capacity, and quality of life in patients with upper lobe-predominant emphysema irrespective of the collateral ventilation. In this review, we emphasize the practical aspects of this ELVR method. Patients with upper lobe-predominant emphysema, forced expiratory volume in 1 second (FEV1) between 20 and 45% of predicted, residual volume (RV) > 175% of predicted, and carbon monoxide diffusing capacity (DLCO) ≥20% of predicted can be considered for BTVA treatment. Prior to the procedure, a special software assists in identifying the target segments with the highest emphysema index, volume and the highest heterogeneity index to the untreated ipsilateral lung lobes. The procedure may be performed under deep sedation or preferably under general anesthesia. After positioning of the BTVA catheter and occlusion of the target segment by the occlusion balloon, heated water vapor is delivered in a predetermined specified time according to the vapor dose. After the procedure, patients should be strictly monitored to proactively detect symptoms of localized inflammatory reaction that may temporarily worsen the clinical status of the patient and to detect complications. As the data are still very limited, BTVA should be performed within clinical trials or comprehensive registries where the product is commercially available.
DOI:doi:10.1159/000489815
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: https://doi.org/10.1159/000489815
 Volltext: https://www.karger.com/Article/FullText/489815
 DOI: https://doi.org/10.1159/000489815
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1665281235
Verknüpfungen:→ Zeitschrift

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