Comparison of plethysmographic and helium dilution lung volumes in patients with a giant emphysematous bulla as selection criteria for endobronchial valve implant

Alfonso Fiorelli, Roberto Scaramuzzi, Matteo Pierdiluca, Elisabetta Frongillo, Gaetana Messina, Nicola Serra, Alberto De Felice, Mario Santini

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To assess whether the difference in lung volume measured with plethysmography and with the helium dilution technique could differentiate an open from a closed bulla in patients with a giant emphysematous bulla and could be used as a selection criterion for the positioning of an endobronchial valve.

METHODS: We reviewed the data of 27 consecutive patients with a giant emphysematous bulla undergoing treatment with an endobronchial valve. In addition to standard functional and radiological examinations, total lung capacity and residual volume were measured with the plethysmographic and helium dilution technique. We divided the patients into 2 groups, the collapse or the no-collapse group, depending on whether the bulla collapsed or not after the valves were put in position. We statistically evaluated the intergroup differences in lung volume and outcome.

RESULTS: In the no-collapse group (n = 6), the baseline plethysmographic values were significantly higher than the helium dilution volumes, including total lung capacity (188 ± 14 vs 145 ± 13, P = 0.0007) and residual volume (156 ± 156 vs 115 ± 15, P = 0.001). In the collapse group, there was no significant difference in lung volumes measured with the 2 methods. A difference in total lung capacity of ≤ 13% and in residual volume of ≤ 25% measured with the 2 methods predicted the collapse of the bulla with a success rate of 83% and 84%, respectively. Only the collapse group showed significant improvement in functional data.

CONCLUSIONS: Similar values in lung volumes measured with the 2 methods support the hypothesis that the bulla communicates with the airway (open bulla) and thus is likely to collapse when the endobronchial valve is implanted. Further studies are needed to validate our model.

Original languageEnglish
Pages (from-to)534-542
Number of pages9
JournalEuropean Journal of Cardio-thoracic Surgery
Volume52
Issue number3
DOIs
Publication statusPublished - Sep 1 2017

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Helium
Blister
Patient Selection
Lung
Total Lung Capacity
Residual Volume
Indicator Dilution Techniques
Plethysmography

Keywords

  • Journal Article

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Comparison of plethysmographic and helium dilution lung volumes in patients with a giant emphysematous bulla as selection criteria for endobronchial valve implant. / Fiorelli, Alfonso; Scaramuzzi, Roberto; Pierdiluca, Matteo; Frongillo, Elisabetta; Messina, Gaetana; Serra, Nicola; De Felice, Alberto; Santini, Mario.

In: European Journal of Cardio-thoracic Surgery, Vol. 52, No. 3, 01.09.2017, p. 534-542.

Research output: Contribution to journalArticle

Fiorelli, Alfonso ; Scaramuzzi, Roberto ; Pierdiluca, Matteo ; Frongillo, Elisabetta ; Messina, Gaetana ; Serra, Nicola ; De Felice, Alberto ; Santini, Mario. / Comparison of plethysmographic and helium dilution lung volumes in patients with a giant emphysematous bulla as selection criteria for endobronchial valve implant. In: European Journal of Cardio-thoracic Surgery. 2017 ; Vol. 52, No. 3. pp. 534-542.
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T1 - Comparison of plethysmographic and helium dilution lung volumes in patients with a giant emphysematous bulla as selection criteria for endobronchial valve implant

AU - Fiorelli, Alfonso

AU - Scaramuzzi, Roberto

AU - Pierdiluca, Matteo

AU - Frongillo, Elisabetta

AU - Messina, Gaetana

AU - Serra, Nicola

AU - De Felice, Alberto

AU - Santini, Mario

PY - 2017/9/1

Y1 - 2017/9/1

N2 - OBJECTIVES: To assess whether the difference in lung volume measured with plethysmography and with the helium dilution technique could differentiate an open from a closed bulla in patients with a giant emphysematous bulla and could be used as a selection criterion for the positioning of an endobronchial valve.METHODS: We reviewed the data of 27 consecutive patients with a giant emphysematous bulla undergoing treatment with an endobronchial valve. In addition to standard functional and radiological examinations, total lung capacity and residual volume were measured with the plethysmographic and helium dilution technique. We divided the patients into 2 groups, the collapse or the no-collapse group, depending on whether the bulla collapsed or not after the valves were put in position. We statistically evaluated the intergroup differences in lung volume and outcome.RESULTS: In the no-collapse group (n = 6), the baseline plethysmographic values were significantly higher than the helium dilution volumes, including total lung capacity (188 ± 14 vs 145 ± 13, P = 0.0007) and residual volume (156 ± 156 vs 115 ± 15, P = 0.001). In the collapse group, there was no significant difference in lung volumes measured with the 2 methods. A difference in total lung capacity of ≤ 13% and in residual volume of ≤ 25% measured with the 2 methods predicted the collapse of the bulla with a success rate of 83% and 84%, respectively. Only the collapse group showed significant improvement in functional data.CONCLUSIONS: Similar values in lung volumes measured with the 2 methods support the hypothesis that the bulla communicates with the airway (open bulla) and thus is likely to collapse when the endobronchial valve is implanted. Further studies are needed to validate our model.

AB - OBJECTIVES: To assess whether the difference in lung volume measured with plethysmography and with the helium dilution technique could differentiate an open from a closed bulla in patients with a giant emphysematous bulla and could be used as a selection criterion for the positioning of an endobronchial valve.METHODS: We reviewed the data of 27 consecutive patients with a giant emphysematous bulla undergoing treatment with an endobronchial valve. In addition to standard functional and radiological examinations, total lung capacity and residual volume were measured with the plethysmographic and helium dilution technique. We divided the patients into 2 groups, the collapse or the no-collapse group, depending on whether the bulla collapsed or not after the valves were put in position. We statistically evaluated the intergroup differences in lung volume and outcome.RESULTS: In the no-collapse group (n = 6), the baseline plethysmographic values were significantly higher than the helium dilution volumes, including total lung capacity (188 ± 14 vs 145 ± 13, P = 0.0007) and residual volume (156 ± 156 vs 115 ± 15, P = 0.001). In the collapse group, there was no significant difference in lung volumes measured with the 2 methods. A difference in total lung capacity of ≤ 13% and in residual volume of ≤ 25% measured with the 2 methods predicted the collapse of the bulla with a success rate of 83% and 84%, respectively. Only the collapse group showed significant improvement in functional data.CONCLUSIONS: Similar values in lung volumes measured with the 2 methods support the hypothesis that the bulla communicates with the airway (open bulla) and thus is likely to collapse when the endobronchial valve is implanted. Further studies are needed to validate our model.

KW - Journal Article

U2 - 10.1093/ejcts/ezx108

DO - 10.1093/ejcts/ezx108

M3 - Article

C2 - 28444339

VL - 52

SP - 534

EP - 542

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

SN - 1010-7940

IS - 3

ER -