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Browse ATS 2021 Abstracts

HomeProgram ▶ Browse ATS 2021 Abstracts
 

ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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Endoscopic Lung Volume Reduction with Endobronchial Valves in Patients with Hypercapnia: Results of a Prospective Observational Clinical Study

Session Title
A6 - A006 HOT TAKES FROM CLINICAL TRIALS IN LUNG DISEASE
Abstract
A1022 - Endoscopic Lung Volume Reduction with Endobronchial Valves in Patients with Hypercapnia: Results of a Prospective Observational Clinical Study
Author Block: P. Lenga1, C. Grah2, C. Ruwwe-Glösenkamp1, J. Saccomanno1, J. Pfannschmidt3, S. Eggeling4, S. Gläser5, S. Kurz6, G. Leschber7, J. Rückert8, B. Schmidt9, P. Schneider10, A. Gebhardt11, B. Becke12, O. Schega13, A. Holland14, A. Kirschbaum15, S. Eisenmann16, M. Krüger17, R. Hübner1; 1Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany, 2Pneumology, Hospital Havelhoehe, Berlin, Germany, 3Thoracic Surgery, Helios Klinikum Emil von Behring, Berlin, Germany, 4Thoracic Surgery, Vivantes Netzwerk für Gesundheit, Berlin, Germany, 5IPulmonary Medicine and Infectious Diseases, Vivantes-Klinikum Neukölln, Berlin, Germany, 6Respiratory Medicine, ELK Berlin Chest Hospital, Berlin, Germany, 7Thoracic Surgery, ELK Berlin Chest Hospital, Berlin, Germany, 8Thoracic Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany, 9Respiratory Medicine, DRK Kliniken Berlin Mitte, Berlin, Germany, 10Thoracic Surgery, DRK Kliniken Berlin Mitte, Berlin, Germany, 11Internal Medicine and Respiratory Medicine, Helios Klinikum Emil von Behring, Berlin, Germany, 12Respiratory Medicine, Johanniter-Krankenhaus, Treuenbrietzen, Germany, 13Thoracic Surgery, Johanniter-Krankenhaus, Treuenbrietzen, Germany, 14Respiratory Medicine, Uniklinikum Marburg, Marburg, Germany, 15Thoracic Surgery, Uniklinikum Marburg, Marburg, Germany, 16Respiratory Medicine, Universitätsklinik Halle, Halle, Germany, 17Thoracic Surgery, Martha-Maria Clinic, Halle, Germany.
IntroductionChronic obstructive pulmonary disease (COPD) is a debilitating disease and is projected to rank fifth worldwide in terms of burden of disease and in terms of mortality. As clinical evidence on endoscopic lung volume reduction accumulates, it seems that endoscopic procedures like the implantation of endobronchial valves (ELVR) can produce good clinical outcome for both quality of life and lung function parameters. However, there is still a lack of robust clinical evidence on the efficacy and safety of endobronchial valves in patients with hypercapnia (partial pressure of carbon dioxide in arterial blood (PaCO2)>45mmHg). The scope and the focus of this sub-analysis are to present data on outcomes in relation to PaCO2 of patients treated with valves. MethodsAll data were extracted from the German Lung Emphysema Registry, which is a multicenter open-label prospective clinical study collecting data exclusively on patients with severe emphysema. We assessed PaCO2 at baseline and 3-months follow up and compared pre-and postprocedural the lung function test, the quality of life, exercise capacity and the occurrence of adverse events. Results197 patients treated with endobronchial valves were eligible for this study. 157 patients with a PaCO2≤ 45 mmHg and 40 patients with a PaCO2>45mmHg showed similar baseline characteristics. At baseline, patients PaCO2≤ 45 mmHg showed significant higher levels of FEV1 (31.6%± 9.5) and lower levels of RV (249.8%± 52.5) compared to those with hypercapnia (FEV1: 29.6±10.4, p=0.001; RV: 271.9±60.1, p=0.001). After ELVR, there was a significant improvement of FEV1, RV,6-MWD and mMRC at 3-months follow up in the PaCO2≤45 mmHg group (p<0.05 to baseline). PaCO2 and RV improved also significantly in patients with a PaCO2>45 mmHg at 3 months follow up (p<0.05 to baseline). In direct comparison at 3-months follow up, ΔPaCO2 improved significantly in patients with hypercapnia (ΔPaCO2 -8.4±13.4) compared to those without ΔPaCO2 -1.1±7.7; p=0.013). Most frequent complication for both groups was the presence of pneumothorax. Not a single death occurred in patients with a PaCO2>45mmHg. Notwithstanding, no significant differences were observed in both groups. ConclusionELVR seems to produce favorable clinical outcomes in patients with PaCO2>45 mmHg and PaCO2≤45 mmHg. Notably, there was a significant decrease of PaCO2 in patients with hypercapnia after 3-months-follow up. Additionally, adverse events did not differ between groups. These findings are paramount since they accentuate that the implantation of endobronchial valves even in patients with hypercapnia can lead to better clinical outcomes and present with a safety profile for the hypercapnic patients.