The Localized Inflammatory Response to Bronchoscopic Thermal Vapor Ablation

Daniela Gompelmann; Ralf Eberhardt; Armin Ernst; Peter Hopkins; Jim Egan; Franz Stanzel; Arschang Valipour; Manfred Wagner; Christian Witt; Kimberly M. Baker; Mark H. Gotfried; Steven Kesten; Gregory Snell; Felix J. F. Herth

doi:10.1159/000354175

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The Localized Inflammatory Response to Bronchoscopic Thermal Vapor Ablation

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The Localized Inflammatory Response to Bronchoscopic Thermal Vapor Ablation

Daniela Gompelmann, Ralf Eberhardt, Armin Ernst, Peter Hopkins, Jim Egan, Franz Stanzel, Arschang Valipour, Manfred Wagner, Christian Witt, Kimberly M. Baker, …

Respiration, Vol.86(4), pp.324-331

01/01/2013

DOI: 10.1159/000354175

PMID: 23988888

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Abstract

Background: Bronchoscopic thermal vapor ablation (BTVA) reduces lung volumes in emphysema patients by inducing a localized inflammatory response (LIR) leading to a healing process of fibrosis, but may also increase symptoms. Objectives: We sought to evaluate whether the clinical manifestation of LIR correlated with patient outcome. Methods: Respiratory adverse events and inflammatory markers were analyzed from a multicenter trial of BTVA in patients with upper-lobe-predominant emphysema. End points including changes in forced expiratory flow (FEV1), lobar volume, St. George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) and 6-minute-walk distance (6MWD) were analyzed according to the presence or absence of a respiratory adverse event requiring treatment with an antibiotic or steroid. Results: Forty-four patients received BTVA. Increases of inflammatory markers were observed with a peak between the second and fourth week. Eighteen respiratory adverse events occurred in 16 patients within 30 days of BTVA, requiring antibiotics and/or steroids. These patients had significantly greater lobar volume reduction (65.3 vs. 33.4%, p = 0.007) and a change in residual volume at 12 months (-933 vs. 13 ml, p < 0.001) associated with a greater improvement of exercise capacity and health-related quality of life than patients without respiratory adverse events. Conclusion: Patients with more prominent respiratory symptoms in the first 30 days following BTVA experience greater efficacy. The clinical manifestations of the LIR are predictive of long-term clinical benefits. Copyright (C) 2013 S. Karger AG, Basel

Life Sciences & Biomedicine

Respiratory System

Science & Technology

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Title: Subtitle: The Localized Inflammatory Response to Bronchoscopic Thermal Vapor Ablation
Creators: Daniela Gompelmann - Heidelberg University
Ralf Eberhardt - Heidelberg Univ, Thoraxklin, Heidelberg, Germany
Armin Ernst - Catholic Development Office
Peter Hopkins - Prince Charles Hosp, Lung Transplant Unit, Chermside, Qld, Australia
Jim Egan - Mater Foundation
Franz Stanzel - Zentrum Pneumol, Hemer, Germany
Arschang Valipour - Otto Wagner Hosp, Ludwig Boltzmann Inst COPD, Vienna, Austria
Manfred Wagner - Klinikum Nurnberg, Nurnberg, Germany
Christian Witt - Charité - Universitätsmedizin Berlin
Kimberly M. Baker - University of Iowa
Mark H. Gotfried - Phoenix (United States)
Steven Kesten - Uptake Med Corp, Tustin, CA USA
Gregory Snell - Alfred Hosp, Melbourne, Vic, Australia
Felix J. F. Herth - Heidelberg University
Resource Type: Journal article
Publication Details: Respiration, Vol.86(4), pp.324-331
DOI: 10.1159/000354175
PMID: 23988888
NLM abbreviation: Respiration
ISSN: 0025-7931
eISSN: 1423-0356
Publisher: Karger
Number of pages: 8
Language: English
Date published: 01/01/2013
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984695831802771

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