Introduction: Bronchoscopic lung volume reduction (BLVR) with endobronchial valves has been shown to be a safe and effective treatment for patients with severe lung emphysema. Previous studies have reported a benefit in pulmonary function, exercise capacity, and quality of life after BLVR-treatment. The effect of BLVR with valves on the pulmonary gas exchange and its association with clinical outcomes has not been analyzed to date. The primary goal of this study was to investigate the impact of BLVR on the pulmonary gas exchange and the impact of the target lobe selection in patients with discordant target lobes in high-resolution computed tomography (HRCT) scan and perfusion scan on the pulmonary gas exchange and clinical outcomes. Methods: In this single-center study, we retrospectively analyzed pulmonary function tests, 6-min-walk-tests, HRCT scans, perfusion scans, and blood gas analyses in 77 patients over the course of 6 months following BLVR treatment. Results: We observed that complete lobar occlusion with bronchoscopic valves leads to a transient impairment of pulmonary gas exchange. Despite this, an overall positive clinical outcome could be shown in patients treated with endobronchial valves. If the target lobe selection based on HRCT and perfusion scans is discrepant, a selection based on the HRCT scan tends to be associated with a better outcome than a selection based on the perfusion scan. Conclusions: Complete lobar occlusion with bronchoscopic valves leads to a transient impairment of pulmonary gas exchange but nevertheless results in an overall positive clinical outcome.

中文翻译：

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支气管镜肺减容术对肺气体交换的影响

简介：支气管镜肺减容术（BLVR）已被证明是治疗严重肺气肿患者安全有效的方法。先前的研究报告称 BLVR 治疗后肺功能、运动能力和生活质量都有所改善。迄今为止，带瓣膜的 BLVR 对肺气体交换的影响及其与临床结果的关系尚未进行分析。本研究的主要目的是探讨 BLVR 对肺气体交换的影响以及高分辨率计算机断层扫描 (HRCT) 扫描和灌注扫描中靶叶不一致患者的靶叶选择对肺气体交换的影响和临床结果。方法：在这项单中心研究中，我们回顾性分析了 77 名患者接受 BLVR 治疗后 6 个月内的肺功能测试、6 分钟步行测试、HRCT 扫描、灌注扫描和血气分析。结果：我们观察到支气管镜瓣膜完全闭塞肺叶会导致肺部气体交换短暂受损。尽管如此，接受支气管内瓣膜治疗的患者仍可显示出总体积极的临床结果。如果基于 HRCT 和灌注扫描的目标叶选择不一致，则基于 HRCT 扫描的选择往往比基于灌注扫描的选择具有更好的结果。结论：支气管镜瓣膜完全肺叶闭塞会导致肺部气体交换短暂受损，但仍会产生总体积极的临床结果。