Open AccessPrevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves
Author(s) -
AbiaTrujillo David,
Yu LeeMateus Alejandra,
GarciaSaucedo 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.,
DuloheryScrodin Megan M.,
Reisenauer Janani S.,
Mehta Hiren J.,
Jantz Michael A.,
Abbas Hawazin K.,
FernandezBussy Sebastian
Publication year - 2022
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.13450
Subject(s) - medicine , pulmonary disease , exacerbation , lung volume reduction , lung , copd , bronchoscopy , intensive care medicine , obstructive lung disease , radiology
Abstract 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.