CHEST Guidelines-Lung-Volume-Reduction-in-Emphysema-Improves-Chest- (1)

Lung-Volume-Reduction-in-Emphysema-Improves-Chest- (1)

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A study published in CHEST journal in 2015 by Zaid Zoumot and colleagues investigated the effects of lung volume reduction (LVR) on chest wall asynchrony in emphysema patients. Emphysema often causes asynchronous movements between different compartments of the chest wall during breathing, contributing to respiratory difficulties. The study aimed to evaluate how effective LVR techniques are in addressing this issue.<br /><br />The researchers used optoelectronic plethysmography to precisely measure the effects of RVR on chest wall movement in 26 patients divided into those receiving surgery, those who received bronchoscopic LVR, and a control group that underwent sham or unsuccessful treatments. These techniques were employed to quantify chest wall asynchrony by examining phase shifts between the pulmonary ribcage (Vrc,p), abdominal ribcage (Vrc,a), and abdomen (Vab).<br /><br />Before treatment, patients exhibited notable chest wall asynchrony. Following successful LVR, significant improvements in lung function and reductions in chest wall asynchrony were observed, moving toward perfect synchrony, as noted in phase shift angles during quiet breathing. Specifically, reductions in asynchrony were particularly evident on the treated side, indicating the effectiveness of LVR procedures.<br /><br />The study suggests that improvements in chest wall asynchrony go hand-in-hand with enhancing lung mechanics and reducing hyperinflation. This enhanced synchrony is likely associated with alleviated symptoms and improved breathing efficiency, suggesting that LVR may be particularly beneficial for patients with severe hyperinflation, potentially helping healthcare providers better select candidates who might benefit from LVR interventions. The beneficial effects of improved synchronous movement in the chest wall post-LVR indicate a significant impact on clinical outcomes such as lung function and exercise capacity.<br /><br />This research underscores the value of LVR procedures in improving respiratory mechanics and quality of life for patients with emphysema, highlighting the potential of optoelectronic plethysmography in assessing treatment outcomes.

Keywords

lung volume reduction

emphysema

chest wall asynchrony

optoelectronic plethysmography

respiratory mechanics

hyperinflation

Zaid Zoumot

CHEST journal

lung function

breathing efficiency