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Unilateral extrapulmonary airway bypass in advanced emphysema
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2010 (English)In: The Annals of thoracic surgery, ISSN 1552-6259, Vol. 89, no 3, p. 899-906, 906.e1Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Gas trapping in emphysema results in resting and dynamic hyperinflation. We tested the hypothesis that a direct connection between the lung parenchyma and the atmosphere could increase expiratory flow and thereby potentially improve dyspnea through the relief of gas trapping. METHODS: Ex vivo we studied 7 emphysematous lungs and 3 fibrotic lungs (as controls) and measured expiratory flow before and after airway bypass insertion during a forced maneuver in an artificial thorax. Pilot studies were conducted in vivo in 6 patients with advanced emphysema using a size 9 endotracheal tube as a bypass surgically placed through the chest wall into the upper lobe. RESULTS: In the ex vivo emphysematous lungs the volume expelled during a forced expiratory maneuver increased from 169 to 235 mL (p < 0.05). In the in vivo group 4 patients retained the bypass tube for 3 months or more; total lung capacity was reduced, and the forced expiratory volume in 1 second increased by 23% (mean percent predicted at baseline versus 3 months, 24.4% versus 29.5%). CONCLUSIONS: An extrapulmonary airway bypass increases expiratory flow in emphysema. This may be a useful approach in hyperinflated patients with homogeneous emphysema.

Place, publisher, year, edition, pages
2010. Vol. 89, no 3, p. 899-906, 906.e1
Keywords [en]
Emphysema
National Category
Nursing
Identifiers
URN: urn:nbn:se:shh:diva-158DOI: 10.1016/j.athoracsur.2009.10.067PubMedID: 20172151OAI: oai:DiVA.org:shh-158DiVA, id: diva2:314984
Available from: 2010-04-28 Created: 2010-04-28 Last updated: 2010-04-28Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • ieee
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  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
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  • text
  • asciidoc
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