Additive effect on pulmonary function and disability of intensive pulmonary rehabilitation following bronchoscopy lung volume reduction (BLVR) for severe emphysema

Luca Bianchi, Michela Bezzi, Marialma Berlendis, Simona Marino, Alessandra Montini, Mara Paneroni, Mauro Novali, Gundi Steinhilber, Michele Vitacca

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Abstract

BACKGROUND: Pulmonary rehabilitation (PR) is mandatory before bronchoscopy lung volume reduction (BLVR); there is scant information about its efficacy post-BLVR. We retrospectively evaluated pulmonary function (PF) and disability in patients pre/post-BLVR and its additive effect on an intensive PR program post-BLVR vs matched non-BLVR controls. We analyzed changes within BLVR patients according to presence or not of atelectasis.

METHODS: We compared PF and exercise tolerance (6-min walk test, 6MWT) in 39 BLVR patients (FEV1% pred. 28.9 ± 1.5; RV% pred. 236.1 ± 7.7) pre-/post-BLVR, and vs. 32 controls (FEV1% pred. 32.7 ± 1.5; RV % pred. 217.8 ± 8.3) before and after PR.

RESULTS: BLVR patients showed a greater improvement than controls in PF (difference between groups: 3.8 for FEV1% pred., p = 0.043; -20.5 for RV % pred., p = 0.02) and 6MWT response rate (12/39 vs. 1/39 subjects, p = 0.003). Both groups further improved significantly 6MWT after PR without a significant difference between groups. Atelectasis after BLVR mainly accounted for the improvement in FEV1% pred, RV% pred. and 6MWT compared to both BLVR without atelectasis and controls.

CONCLUSION: BLVR improves PF (particularly RV) and exercise tolerance, patients with lobar exclusion being the best improvers. PR following BLVR yields a further improvement in exercise tolerance in both (atelectasis and non-atelectasis) subgroups.

Original languageEnglish
Pages (from-to)116-122
Number of pages7
JournalRespiratory Medicine
Volume143
DOIs
Publication statusPublished - Oct 2018

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Pneumonectomy
Emphysema
Bronchoscopy
Rehabilitation
Lung
Pulmonary Atelectasis
Exercise Tolerance
prednylidene

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Additive effect on pulmonary function and disability of intensive pulmonary rehabilitation following bronchoscopy lung volume reduction (BLVR) for severe emphysema. / Bianchi, Luca; Bezzi, Michela; Berlendis, Marialma; Marino, Simona; Montini, Alessandra; Paneroni, Mara; Novali, Mauro; Steinhilber, Gundi; Vitacca, Michele.

In: Respiratory Medicine, Vol. 143, 10.2018, p. 116-122.

Research output: Contribution to journalArticle

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title = "Additive effect on pulmonary function and disability of intensive pulmonary rehabilitation following bronchoscopy lung volume reduction (BLVR) for severe emphysema",
abstract = "BACKGROUND: Pulmonary rehabilitation (PR) is mandatory before bronchoscopy lung volume reduction (BLVR); there is scant information about its efficacy post-BLVR. We retrospectively evaluated pulmonary function (PF) and disability in patients pre/post-BLVR and its additive effect on an intensive PR program post-BLVR vs matched non-BLVR controls. We analyzed changes within BLVR patients according to presence or not of atelectasis.METHODS: We compared PF and exercise tolerance (6-min walk test, 6MWT) in 39 BLVR patients (FEV1{\%} pred. 28.9 ± 1.5; RV{\%} pred. 236.1 ± 7.7) pre-/post-BLVR, and vs. 32 controls (FEV1{\%} pred. 32.7 ± 1.5; RV {\%} pred. 217.8 ± 8.3) before and after PR.RESULTS: BLVR patients showed a greater improvement than controls in PF (difference between groups: 3.8 for FEV1{\%} pred., p = 0.043; -20.5 for RV {\%} pred., p = 0.02) and 6MWT response rate (12/39 vs. 1/39 subjects, p = 0.003). Both groups further improved significantly 6MWT after PR without a significant difference between groups. Atelectasis after BLVR mainly accounted for the improvement in FEV1{\%} pred, RV{\%} pred. and 6MWT compared to both BLVR without atelectasis and controls.CONCLUSION: BLVR improves PF (particularly RV) and exercise tolerance, patients with lobar exclusion being the best improvers. PR following BLVR yields a further improvement in exercise tolerance in both (atelectasis and non-atelectasis) subgroups.",
author = "Luca Bianchi and Michela Bezzi and Marialma Berlendis and Simona Marino and Alessandra Montini and Mara Paneroni and Mauro Novali and Gundi Steinhilber and Michele Vitacca",
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year = "2018",
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language = "English",
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T1 - Additive effect on pulmonary function and disability of intensive pulmonary rehabilitation following bronchoscopy lung volume reduction (BLVR) for severe emphysema

AU - Bianchi, Luca

AU - Bezzi, Michela

AU - Berlendis, Marialma

AU - Marino, Simona

AU - Montini, Alessandra

AU - Paneroni, Mara

AU - Novali, Mauro

AU - Steinhilber, Gundi

AU - Vitacca, Michele

N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.

PY - 2018/10

Y1 - 2018/10

N2 - BACKGROUND: Pulmonary rehabilitation (PR) is mandatory before bronchoscopy lung volume reduction (BLVR); there is scant information about its efficacy post-BLVR. We retrospectively evaluated pulmonary function (PF) and disability in patients pre/post-BLVR and its additive effect on an intensive PR program post-BLVR vs matched non-BLVR controls. We analyzed changes within BLVR patients according to presence or not of atelectasis.METHODS: We compared PF and exercise tolerance (6-min walk test, 6MWT) in 39 BLVR patients (FEV1% pred. 28.9 ± 1.5; RV% pred. 236.1 ± 7.7) pre-/post-BLVR, and vs. 32 controls (FEV1% pred. 32.7 ± 1.5; RV % pred. 217.8 ± 8.3) before and after PR.RESULTS: BLVR patients showed a greater improvement than controls in PF (difference between groups: 3.8 for FEV1% pred., p = 0.043; -20.5 for RV % pred., p = 0.02) and 6MWT response rate (12/39 vs. 1/39 subjects, p = 0.003). Both groups further improved significantly 6MWT after PR without a significant difference between groups. Atelectasis after BLVR mainly accounted for the improvement in FEV1% pred, RV% pred. and 6MWT compared to both BLVR without atelectasis and controls.CONCLUSION: BLVR improves PF (particularly RV) and exercise tolerance, patients with lobar exclusion being the best improvers. PR following BLVR yields a further improvement in exercise tolerance in both (atelectasis and non-atelectasis) subgroups.

AB - BACKGROUND: Pulmonary rehabilitation (PR) is mandatory before bronchoscopy lung volume reduction (BLVR); there is scant information about its efficacy post-BLVR. We retrospectively evaluated pulmonary function (PF) and disability in patients pre/post-BLVR and its additive effect on an intensive PR program post-BLVR vs matched non-BLVR controls. We analyzed changes within BLVR patients according to presence or not of atelectasis.METHODS: We compared PF and exercise tolerance (6-min walk test, 6MWT) in 39 BLVR patients (FEV1% pred. 28.9 ± 1.5; RV% pred. 236.1 ± 7.7) pre-/post-BLVR, and vs. 32 controls (FEV1% pred. 32.7 ± 1.5; RV % pred. 217.8 ± 8.3) before and after PR.RESULTS: BLVR patients showed a greater improvement than controls in PF (difference between groups: 3.8 for FEV1% pred., p = 0.043; -20.5 for RV % pred., p = 0.02) and 6MWT response rate (12/39 vs. 1/39 subjects, p = 0.003). Both groups further improved significantly 6MWT after PR without a significant difference between groups. Atelectasis after BLVR mainly accounted for the improvement in FEV1% pred, RV% pred. and 6MWT compared to both BLVR without atelectasis and controls.CONCLUSION: BLVR improves PF (particularly RV) and exercise tolerance, patients with lobar exclusion being the best improvers. PR following BLVR yields a further improvement in exercise tolerance in both (atelectasis and non-atelectasis) subgroups.

U2 - 10.1016/j.rmed.2018.09.006

DO - 10.1016/j.rmed.2018.09.006

M3 - Article

C2 - 30261982

VL - 143

SP - 116

EP - 122

JO - Respiratory Medicine

JF - Respiratory Medicine

SN - 0954-6111

ER -