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

Research output: Contribution to journalArticlepeer-review

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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