Bronchoscopic lung volume reduction (BLVR) procedure has expanded the treatment spectrum of patients with end-stage emphysema. These treatments include valve, coil, thermal vapor ablation, bio-lung volume reduction, targeted lung denervation, and airway bypass stent. This short review provides an up-to-date information on BLVR treatments, their clinical benefits, and an overview of complications. BLVR treatments generally affect dyspnea by reducing hyperinflation and residual volume (RV). Benefits of treatment are associated with improvement in lung function parameters (forced expiration volume in the first second, total lung capacity, RV, and 6-minute walking test) and quality of life. Serious potential pulmonary complications, such as pneumothorax, pneumonia, respiratory failure, and chronic obstructive pulmonary disease exacerbation, may also occur after BLVR treatment. In addition to these, low-cost BLVR methods, such as autologous blood and fibrin glue, are in the developmental stage. Bronchoscopic lung volume reduction treatments are a promising method with positive results for patients with severe emphysema. The widespread use of these techniques, inadequate selection of patients, and non-critical and, therefore, unsuccessful use of BLVR in non-specialist centers lead to a false negative impression of the effectiveness of these techniques. In addition to these considerations, it is obvious that these treatments, which are quite expensive, are burdening social health systems. The reduction of costs or the development of lower-cost treatment methods is important for the future and for the availability of treatments.

Bronchoscopic Lung Volume Reduction: A 2018 Review and Update.

Introduction
Bronchoscopic lung volume reduction coil (BLVR-C) implantation is an alternative therapeutic approach that can be applied together with medical treatment for patients with severe emphysema. BLVR-C is both easier and safer in terms of complications than volume reduction surgery. This study aimed to evaluate medium-term outcomes following BLVR-C treatment.

Methods
Forty patients who underwent BLVR-C between September 2013 and March 2014 were reviewed retrospectively. We compared changes between the baseline and 6-month post-procedural results with respect to pulmonary function tests, a 6-min walk test (6MWT), chronic obstructive pulmonary disease (COPD) assessment test (CAT), St. George's Respiratory Questionnaire (SGRQ), and pulmonary artery pressure (PAP) and arterial blood gas analyses. Secondary outcomes included procedure-related and follow-up complications.

Results
An average of 9.5 (range: 5–11) coils were placed per lung in an average procedural duration of 20.8 ± 7.0 min (range: 9–45) min. Six months after BLVR-C treatment, significant improvements were observed in patients’ pulmonary function tests and quality of life. Changes were observed in the forced exhalation volume in 1 s (+150 mL), residual volume (−14.5%), 6MWT (+48 m), SGRQ (−10.5) and CAT Score (−7.5). Changes in the PAP and partial pressure of carbon dioxide values were not significant, and pneumothorax did not occur. In a 6-month follow-up, 11 cases of COPD exacerbation (41.4%), 7 cases of pneumonia (16.9%) and 1 death (2%) occurred. Treatment in 1 case was postponed because of hypotension and bradycardia during the process.

Conclusion
BLVR-C treatment appears to be effective over the medium-term and safe for patients with severe emphysema.

Evaluation of bronchoscopic lung volume reduction coil treatment results in patients with severe emphysema

Pneumologische Erkrankungen gehen oft mit schweren, fur Patienten beangstigenden Symptomen einher: Luftnot, Schmerzen, Husten und zahes Sekret. Pflegende sind hiermit unmittelbar konfrontiert, Kenntnisse der Therapieoptionen sind somit unabdingbar. Neben der Vermittlung von medikamentosen Basistherapien sollen in diesem Kapitel vor allem nichtmedikamentose Ansatze wie effizientes Sekretmanagement, pulmonale Entblahung oder Mobilisation zum Tragen kommen und so den Handlungsraum von Pflegenden erweitern. Die Indikation und Applikation von Sauerstoff sowie nichtinvasive Beatmungstherapien werden in Grundzugen erlautert, daruber hinaus werden interventionelle Therapien (endoskopisch und chirurgisch) vorgestellt.

Kausale und symptomatische Therapie

Reversibilität der Implantation von RePneu Coils

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Reversibilität der Implantation von RePneu Coils