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Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status

BACKGROUND: Central airway obstruction (CAO) is a potentially lethal condition that requires urgent endobronchial intervention and may occur due to several nonmalignant causes. The effect of these interventions on clinically relevant outcomes such as symptomatic and functional status over a period o...

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Autores principales: Shrestha, Prajowl, Madan, Karan, Hadda, Vijay, Upadhyay, Ashish, Mittal, Saurabh, Tiwari, Pawan, Pandey, R. M., Garg, Rakesh, Khilnani, G. C., Guleria, Randeep, Mohan, Anant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507926/
https://www.ncbi.nlm.nih.gov/pubmed/32643636
http://dx.doi.org/10.4103/lungindia.lungindia_476_19
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author Shrestha, Prajowl
Madan, Karan
Hadda, Vijay
Upadhyay, Ashish
Mittal, Saurabh
Tiwari, Pawan
Pandey, R. M.
Garg, Rakesh
Khilnani, G. C.
Guleria, Randeep
Mohan, Anant
author_facet Shrestha, Prajowl
Madan, Karan
Hadda, Vijay
Upadhyay, Ashish
Mittal, Saurabh
Tiwari, Pawan
Pandey, R. M.
Garg, Rakesh
Khilnani, G. C.
Guleria, Randeep
Mohan, Anant
author_sort Shrestha, Prajowl
collection PubMed
description BACKGROUND: Central airway obstruction (CAO) is a potentially lethal condition that requires urgent endobronchial intervention and may occur due to several nonmalignant causes. The effect of these interventions on clinically relevant outcomes such as symptomatic and functional status over a period of time is, however, sparsely studied. MATERIALS AND METHODS: Consecutive patients with CAO due to nonmalignant causes and undergoing various therapeutic bronchoscopy procedures were evaluated. Symptoms were assessed using the Visual Analog Scale (VAS) and Speiser score, and functional status was assessed using the 6-min walk test, spirometry, and St. George Respiratory Questionnaire (SGRQ) score at baseline and after 48 h, 4 weeks, and 12 weeks postprocedure. RESULTS: Over 2 years, 31 patients with CAO due to nonmalignant etiology underwent 41 therapeutic bronchoscopic procedures. Majority of procedures (96.8%) were done using the rigid bronchoscope under general anesthesia. Postintubation tracheal stenosis was the most common indication (32.2%). The various procedures included, controlled radial expansion balloon dilatation of the stenotic airway (53.6%), deployment of silicone stents (19.5%), and mechanical debulking of airway tumors (16.1%). Significant improvement occurred in dyspnea and cough scores and in the Speiser score from baseline to 48 h postprocedure, and further improved at 4 weeks and 12 weeks. Similarly, the 6 min walk distance, forced expiratory volume in 1 s, and SGRQ scores progressively improved from baseline to 12 weeks. Complications occurred in 26.8% of total procedures, with no procedure-related mortality. CONCLUSION: Therapeutic bronchoscopy interventions provide rapid and sustained benefits in symptoms and functional status of participants with CAO of nonmalignant etiology, with an acceptable safety profile.
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spelling pubmed-75079262020-10-02 Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status Shrestha, Prajowl Madan, Karan Hadda, Vijay Upadhyay, Ashish Mittal, Saurabh Tiwari, Pawan Pandey, R. M. Garg, Rakesh Khilnani, G. C. Guleria, Randeep Mohan, Anant Lung India Original Article BACKGROUND: Central airway obstruction (CAO) is a potentially lethal condition that requires urgent endobronchial intervention and may occur due to several nonmalignant causes. The effect of these interventions on clinically relevant outcomes such as symptomatic and functional status over a period of time is, however, sparsely studied. MATERIALS AND METHODS: Consecutive patients with CAO due to nonmalignant causes and undergoing various therapeutic bronchoscopy procedures were evaluated. Symptoms were assessed using the Visual Analog Scale (VAS) and Speiser score, and functional status was assessed using the 6-min walk test, spirometry, and St. George Respiratory Questionnaire (SGRQ) score at baseline and after 48 h, 4 weeks, and 12 weeks postprocedure. RESULTS: Over 2 years, 31 patients with CAO due to nonmalignant etiology underwent 41 therapeutic bronchoscopic procedures. Majority of procedures (96.8%) were done using the rigid bronchoscope under general anesthesia. Postintubation tracheal stenosis was the most common indication (32.2%). The various procedures included, controlled radial expansion balloon dilatation of the stenotic airway (53.6%), deployment of silicone stents (19.5%), and mechanical debulking of airway tumors (16.1%). Significant improvement occurred in dyspnea and cough scores and in the Speiser score from baseline to 48 h postprocedure, and further improved at 4 weeks and 12 weeks. Similarly, the 6 min walk distance, forced expiratory volume in 1 s, and SGRQ scores progressively improved from baseline to 12 weeks. Complications occurred in 26.8% of total procedures, with no procedure-related mortality. CONCLUSION: Therapeutic bronchoscopy interventions provide rapid and sustained benefits in symptoms and functional status of participants with CAO of nonmalignant etiology, with an acceptable safety profile. Wolters Kluwer - Medknow 2020 2020-07-01 /pmc/articles/PMC7507926/ /pubmed/32643636 http://dx.doi.org/10.4103/lungindia.lungindia_476_19 Text en Copyright: © 2020 Indian Chest Society http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Shrestha, Prajowl
Madan, Karan
Hadda, Vijay
Upadhyay, Ashish
Mittal, Saurabh
Tiwari, Pawan
Pandey, R. M.
Garg, Rakesh
Khilnani, G. C.
Guleria, Randeep
Mohan, Anant
Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status
title Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status
title_full Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status
title_fullStr Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status
title_full_unstemmed Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status
title_short Therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status
title_sort therapeutic bronchoscopic interventions for nonmalignant central airway obstruction provide rapid and sustained improvement in symptoms and functional status
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507926/
https://www.ncbi.nlm.nih.gov/pubmed/32643636
http://dx.doi.org/10.4103/lungindia.lungindia_476_19
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