Key result
Lung volume reduction surgery improves pulmonary function in emphysema by restoring forced expiratory volumes and the mechanical advantage of inspiratory muscles.
Why the study?
Does lung volume reduction surgery improve pulmonary function in patients with emphysema?
Does lung volume reduction surgery improve pulmonary function in patients with emphysema?
Understanding the physiologic mechanisms of improved pulmonary function after lung volume reduction can help select emphysema patients most likely to benefit from the procedure.
Mechanistic insights may aid LVRS patient selection in emphysema; leaves open prospective validation of selection criteria.
It is not readily apparent how pulmonary function could be improved by resecting portions of the lung in patients with emphysema. In emphysema, elevation in residual volume relative to total lung capacity reduces forced expiratory volumes, increases inspiratory effort, and impairs inspiratory muscle mechanics. Lung volume reduction surgery (LVRS) better matches the size of the lungs to the size of the thorax containing them. This restores forced expiratory volumes and the mechanical advantage of the inspiratory muscles. In patients with heterogeneous emphysema, LVRS may also allow space occupied by cysts to be reclaimed by more normal lung. Newer, bronchoscopic methods for lung volume reduction seek to achieve similar ends by causing localized atelectasis, but may be hindered by the low collateral resistance of emphysematous lung. Understanding of the mechanisms of improved function after LVRS can help select patients more likely to benefit from this approach.
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Fessler et al. (2008) conducted a review in Emphysema. Lung volume reduction surgery (LVRS) was evaluated. Lung volume reduction surgery improves pulmonary function in emphysema by restoring forced expiratory volumes and the mechanical advantage of inspiratory muscles.