A New Oxygen Uptake Measurement Supporting Target Selection for Endobronchial Valve Treatment. 2019

Jorrit B A Welling, and Karin Klooster, and Jean-Paul Charbonnier, and Eva M Van Rikxoort, and Clemens R M Barends, and Huib A M Kerstjens, and Nick H T Ten Hacken, and Jorine E Hartman, and Dirk-Jan Slebos
Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, j.b.a.welling@umcg.nl.

BACKGROUND Adequate target lobe selection for endobronchial valve (EBV) treatment in patients with severe emphysema is essential for treatment success and can be based on emphysema destruction, lobar perfusion, lobar volume, and collateral ventilation. As some patients have >1 target lobe for EBV treatment, we were interested whether we could identify the least functional lobe. OBJECTIVE The objective of this study was to investigate the relationship between endoscopic lobar measurement of oxygen uptake, lobar destruction, and vascular volume, and whether this could help in identifying the least functional lobe and thus optimal target for EBV treatment. METHODS We prospectively included patients who were scheduled for EBV treatment in our hospital. A customized gas analysis setup was used to measure lobar O2 uptake after lobar balloon occlusion. Quantitative CT analysis was performed to assess the degree of emphysematous destruction and lobar arterial and venous volumes. RESULTS Twenty-one (5 male/16 female) patients with emphysema (median age 63 years, FEV1 25% of predicted, residual volume 234% of predicted) were included, and 49 endoscopic lobar measurements were performed. A lower O2 uptake significantly correlated with a higher degree of emphysematous lobar destruction (Spearman's ρ: 0.39, p < 0.01), and lower arterial and venous vascular volumes of the lobes (-0.46 and -0.47, respectively; both p < 0.001). CONCLUSIONS Endoscopic measurement of lobar O2 uptake is feasible in patients with emphysema. Measurement of lobar O2 uptake helped to identify the least functional lobe and can be used as additional tool for EBV target lobe selection.

UI MeSH Term Description Entries
D008176 Lung Volume Measurements Measurement of the amount of air that the lungs may contain at various points in the respiratory cycle. Lung Capacities,Lung Volumes,Capacity, Lung,Lung Capacity,Lung Volume,Lung Volume Measurement,Measurement, Lung Volume,Volume, Lung
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D011013 Pneumonectomy The excision of lung tissue including partial or total lung lobectomy. Bronchoscopic Lung Volume Reduction,Endoscopic Lung Volume Reduction,Lung Volume Reduction,Lung Volume Reduction Surgery,Partial Pneumonectomy,Partial Pneumonectomies,Pneumonectomies,Pneumonectomy, Partial,Reduction, Lung Volume,Volume Reduction, Lung
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011656 Pulmonary Emphysema Enlargement of air spaces distal to the TERMINAL BRONCHIOLES where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions. Emphysema, Pulmonary,Centriacinar Emphysema,Centrilobular Emphysema,Emphysemas, Pulmonary,Focal Emphysema,Panacinar Emphysema,Panlobular Emphysema,Pulmonary Emphysemas,Centriacinar Emphysemas,Centrilobular Emphysemas,Emphysema, Centriacinar,Emphysema, Centrilobular,Emphysema, Focal,Emphysema, Panacinar,Emphysema, Panlobular,Emphysemas, Centriacinar,Emphysemas, Centrilobular,Emphysemas, Focal,Emphysemas, Panacinar,Emphysemas, Panlobular,Focal Emphysemas,Panacinar Emphysemas,Panlobular Emphysemas
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D001784 Blood Gas Analysis Measurement of oxygen and carbon dioxide in the blood. Analysis, Blood Gas,Analyses, Blood Gas,Blood Gas Analyses,Gas Analyses, Blood,Gas Analysis, Blood

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