Cargando…
Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves
INTRODUCTION: Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) has emerged as an important treatment method for patients with severe chronic obstructive pulmonary disease (COPD). Acute exacerbations of COPD (AECOPD) are a frequent complication following BLVR with EBV. Howe...
Autores principales: | , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060109/ https://www.ncbi.nlm.nih.gov/pubmed/34605606 http://dx.doi.org/10.1111/crj.13450 |
_version_ | 1784698449370808320 |
---|---|
author | Abia‐Trujillo, David Yu Lee‐Mateus, Alejandra Garcia‐Saucedo, Juan C. Saifi, Omran Patel, Neal M. Herth, Felix J. F. Woytanowski, John R. Alshelli, Ihab Alevas, Sajive Uribe Becerra, Juan P. Majid, Adnan Edell, Eric S. Dulohery‐Scrodin, Megan M. Reisenauer, Janani S. Mehta, Hiren J. Jantz, Michael A. Abbas, Hawazin K. Fernandez‐Bussy, Sebastian |
author_facet | Abia‐Trujillo, David Yu Lee‐Mateus, Alejandra Garcia‐Saucedo, Juan C. Saifi, Omran Patel, Neal M. Herth, Felix J. F. Woytanowski, John R. Alshelli, Ihab Alevas, Sajive Uribe Becerra, Juan P. Majid, Adnan Edell, Eric S. Dulohery‐Scrodin, Megan M. Reisenauer, Janani S. Mehta, Hiren J. Jantz, Michael A. Abbas, Hawazin K. Fernandez‐Bussy, Sebastian |
author_sort | Abia‐Trujillo, David |
collection | PubMed |
description | INTRODUCTION: Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) has emerged as an important treatment method for patients with severe chronic obstructive pulmonary disease (COPD). Acute exacerbations of COPD (AECOPD) are a frequent complication following BLVR with EBV. However, there is no consensus on the prevention of AECOPD. OBJECTIVES: Our study aims to compare the outcomes of different prophylactic measures on the occurrence of AECOPD after BLVR with EBV. METHODS: We conducted a multicenter, retrospective study of patients who underwent BLVR with EBV at six different institutions. Emphasis was directed towards the specific practices aimed at preventing AECOPD: antibiotics, steroids, antibiotics plus steroids, or no prophylaxis. Subgroups were compared, and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. RESULTS: A total of 170 patients were reviewed. The rate of AECOPD was 21.2% for the full cohort. Patients who received prophylaxis had a significantly lower rate of AECOPD compared with those who did not (16.7% vs. 46.2%; p = 0.001). The rate was lowest in patients who received antibiotics alone (9.2%). There was no significant difference in the rate of AECOPD between patients who received steroids alone or antibiotics plus steroids, compared with the other subgroups. The OR for AECOPD was 4.3 (95% CI: 1.8–10.4; p = 0.001) for patients not receiving prophylaxis and 3.9 (95% CI: 1.5–10.1; p = 0.004) for prophylaxis other than antibiotics alone. CONCLUSIONS: Administration of antibiotics after BLVR with EBV was associated with a lower rate of AECOPD. This was not observed with the use of steroids or in combination with antibiotics. |
format | Online Article Text |
id | pubmed-9060109 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90601092022-07-12 Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves Abia‐Trujillo, David Yu Lee‐Mateus, Alejandra Garcia‐Saucedo, Juan C. Saifi, Omran Patel, Neal M. Herth, Felix J. F. Woytanowski, John R. Alshelli, Ihab Alevas, Sajive Uribe Becerra, Juan P. Majid, Adnan Edell, Eric S. Dulohery‐Scrodin, Megan M. Reisenauer, Janani S. Mehta, Hiren J. Jantz, Michael A. Abbas, Hawazin K. Fernandez‐Bussy, Sebastian Clin Respir J Original Articles INTRODUCTION: Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) has emerged as an important treatment method for patients with severe chronic obstructive pulmonary disease (COPD). Acute exacerbations of COPD (AECOPD) are a frequent complication following BLVR with EBV. However, there is no consensus on the prevention of AECOPD. OBJECTIVES: Our study aims to compare the outcomes of different prophylactic measures on the occurrence of AECOPD after BLVR with EBV. METHODS: We conducted a multicenter, retrospective study of patients who underwent BLVR with EBV at six different institutions. Emphasis was directed towards the specific practices aimed at preventing AECOPD: antibiotics, steroids, antibiotics plus steroids, or no prophylaxis. Subgroups were compared, and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. RESULTS: A total of 170 patients were reviewed. The rate of AECOPD was 21.2% for the full cohort. Patients who received prophylaxis had a significantly lower rate of AECOPD compared with those who did not (16.7% vs. 46.2%; p = 0.001). The rate was lowest in patients who received antibiotics alone (9.2%). There was no significant difference in the rate of AECOPD between patients who received steroids alone or antibiotics plus steroids, compared with the other subgroups. The OR for AECOPD was 4.3 (95% CI: 1.8–10.4; p = 0.001) for patients not receiving prophylaxis and 3.9 (95% CI: 1.5–10.1; p = 0.004) for prophylaxis other than antibiotics alone. CONCLUSIONS: Administration of antibiotics after BLVR with EBV was associated with a lower rate of AECOPD. This was not observed with the use of steroids or in combination with antibiotics. John Wiley and Sons Inc. 2021-10-14 /pmc/articles/PMC9060109/ /pubmed/34605606 http://dx.doi.org/10.1111/crj.13450 Text en © 2021 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Abia‐Trujillo, David Yu Lee‐Mateus, Alejandra Garcia‐Saucedo, Juan C. Saifi, Omran Patel, Neal M. Herth, Felix J. F. Woytanowski, John R. Alshelli, Ihab Alevas, Sajive Uribe Becerra, Juan P. Majid, Adnan Edell, Eric S. Dulohery‐Scrodin, Megan M. Reisenauer, Janani S. Mehta, Hiren J. Jantz, Michael A. Abbas, Hawazin K. Fernandez‐Bussy, Sebastian Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves |
title | Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves |
title_full | Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves |
title_fullStr | Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves |
title_full_unstemmed | Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves |
title_short | Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves |
title_sort | prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060109/ https://www.ncbi.nlm.nih.gov/pubmed/34605606 http://dx.doi.org/10.1111/crj.13450 |
work_keys_str_mv | AT abiatrujillodavid preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT yuleemateusalejandra preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT garciasaucedojuanc preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT saifiomran preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT patelnealm preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT herthfelixjf preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT woytanowskijohnr preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT alshelliihab preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT alevassajive preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT uribebecerrajuanp preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT majidadnan preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT edellerics preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT duloheryscrodinmeganm preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT reisenauerjananis preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT mehtahirenj preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT jantzmichaela preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT abbashawazink preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves AT fernandezbussysebastian preventionofacuteexacerbationofchronicobstructivepulmonarydiseaseafterbronchoscopiclungvolumereductionwithendobronchialvalves |