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Effects on ventilation of Lung Volume Reduction Surgery in Emphysema
Author(s) -
Bartels Matthew N,
Gerardo Renee E,
Layton Aimee M,
Downey John A,
Demeersman Ronald E
Publication year - 2009
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.23.1_supplement.955.10
Subject(s) - lung volume reduction surgery , medicine , ventilation (architecture) , randomization , cardiology , lung volumes , anesthesia , randomized controlled trial , lung , mechanical engineering , engineering
AIM To evaluate efficiency of ventilation during exercise in emphysema after lung volume reduction surgery (LVRS) compared to medical treatment (MED). METHODS 41 patients with emphysema were randomized into LVRS (33) or MED (8). Data were compared from a cardiopulmonary exercise test (CPX) using a 5 or 10 watt protocol. CPX was performed at baseline and 12 months post randomization. T‐test with a Bonferroni correction was used determine statistical differences at p<0.01. RESULTS Baseline demographics and exercise evaluations were the same between groups. LVRS demonstrated improved work capacity [37 (17) vs 50 (18) Watts, p<0.01], improved PetCO2 [42.9 (6.0) to 38.4 (3.8) mmHg, p<0.001)], and increased ventilation [(VE) (24.9 (7.2) vs 31.6 (10.6) liters/min, p<0.005)] while no change was found in the MED group. At 12 months LVRS improved versus MED for VE [(31.6 (10.6) vs 22.1 (6.9) liters/min, p<0.01)], and Wattage [50 (18) vs 33 (15) Watts, p<0.005], with a trend in PetCO2 [38.4 (3.8) vs 47.1 (8.7) mmHg, p<0.001]. DISCUSSION LVRS improved ventilation allowing improved exercise capacity. These improvements may be due to removal of alveolar dead space in the LVRS group with improved pulmonary mechanics and improved ventilatory efficiency. Further elucidation of the mechanisms of improvement needs to be done with more detailed analysis of ventilatory mechanics with exercise. Supported by the VIDDA foundation