Bronchoscopic Lung Volume Reduction: A 2018 Review and Update

Bronchoscopic Lung Volume Reduction: A 2018 Review and UpdateAt present, standard treatment options include smoking cessation, bronchodilation, mucolytic agents, phosphodiesterase 4 inhibitors, respiratory rehabilitation, and nutritional support, vaccination against influenza and pneumococcus, and long-term oxygen therapy [4].These treatments help to increase the exercise capacity of patients and decrease symptom exacerbation.However, they do not cure the pathophysiology of the disease or prevent disease progression.In the last decade, in addition to lung volume reduction surgeries (LVRSs), bronchoscopic lung volume reduction (BLVR) has expanded the treatment spectrum of patients with end-stage emphysema [5,6].These treatments include valve, coil, thermal vapor ablation (TVA), bio-lung volume reduction (BioLVR), targeted lung denervation (TLD), and airway bypass stent (ABS).Lung volume reduction surgeries is based on the principle of resecting damaged lung parenchyma and reducing hyperinflation in selected patients with heterogeneous emphysema with upper lobe predominance.Patients are often selected for surgery in accordance with the National Emphysema Treatment Trial (NETT) criteria [5].Patients with hypercapnic respiratory failure, which is defined as an arterial partial pressure of carbon dioxide (PaCO 2 ) >60 mmHg, and oxygen therapy requirement during rest are not recommended for surgery.LVRS can reportedly improve exercise capacity, lung