Bronchoscopy Safety in Patients With Chronic Obstructive Lung Disease

Background: Flexible bronchoscopy is a safe and minimally invasive diagnostic tool used by pulmonologists, but few studies have prospectively compared outcomes in patients with objectively defined obstructive lung disease to those without obstruction. Methods: We determined whether complications in patients undergoing moderate sedation bronchoscopy differ in those without obstruction compared with chronic obstructive pulmonary disease (COPD). We prospectively followed all patients undergoing moderate sedation bronchoscopy in an inpatient or outpatient setting. Results: Over 12 months, data were collected prospectively in 258 patients. A total o 151 patients had pulmonary function testing with classification of COPD according to GOLD Criteria. Sixty-seven of those patients (44%) had COPD: 6 mild (9%), 29 moderate (42%), 27 severe (41%), and 5 very severe (8%). COPD patients were more likely to receive outpatient inhaled corticosteroids and long-acting bronchodilators and anticholinergics (P
Source: Journal of Bronchology and Interventional Pulmonology - Category: Respiratory Medicine Tags: Original Investigations Source Type: research

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Chronic obstructive pulmonary disease is a condition characterized by progressive airflow limitation caused by airway and parenchymal inflammation. Current medical therapies, including bronchodilators, corticosteroids, and anti-inflammatory medications, have been shown to variably improve pulmonary function or quality of life without providing a long-term mortality benefit. Mortality benefits to therapy have been demonstrated in only 2 therapeutic interventions to date: long-term use of daily supplemental oxygen and surgical lung volume reduction (LVRS) for upper-lobe–predominant disease in patients with a low baseli...
Source: Journal of Thoracic Imaging - Category: Radiology Tags: Symposium: Imaging of Innovative and Contemporary Thoracic Interventions: State-of-the-Art Source Type: research
Conclusion: As for cardiac or hepatic transplantations, despite a strong immunosuppressive regimen, a high frequency of transient PF4/H Ab is observed in patients undergoing BLT. Their appareance is not related to thrombocytopenia and/or thrombotic events. However, they could be an early marker of a cellular reaction againts the graft.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - Category: Hematology Authors: Tags: 311. Disorders of Platelet Number or Function: Poster II Source Type: research
Conclusions: COPD patients with higher blood eosinophils, have more IgA, IgM and increased plasma cell gene signature in the bronchial airway. While this may play a role in reducing bacterial colonisation in these patients, further work is required to determine if this is a direct role of eosinophils or whether this is secondary to the higher, local inflammation observed in eosinophilic COPD patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway Cell Biology and Immunopathology Source Type: research
Background: Active smoking promotes small airway abnormality (SAA), an early COPD lesion. Smoking also increases maturation of lung dendritic cells (DC), and decreases CD4+ T cells in bronchoalveolar lavage (BAL). DC control adaptive immunity by activating or tolerizing T cells, but whether lung DC impact SAA is unknown.Aim: To define if BAL DC subsets (cDC1, cDC2, pDC) in current- and ex-smokers correlate with parametric response mapping functional small airways disease (PRMfSAD), a surrogate for histologic SAA, and with BAL CD4+ T cell numbers.Methods: We used flow cytometry to phenotype and quantify DC and CD4+ T cells ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway Cell Biology and Immunopathology Source Type: research
Conclusion: These results confirmed our early observations that balloon dilatation and curettage is safe and successful technique for medical treatment-resistant COPD.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
We previously reported satisfactory results with the Karakoca resector balloon in 10 patients with stage IV chronic obstructive pulmonary disease (COPD) who did not respond to medical treatment. In this article, we present the outcomes of the Karakoca resector balloon dilatation and curettage technique in a larger case series (n = 188). A total of 188 COPD patients [mean age (SD): 69.2 (8.0) years; 46 females] classified as stage III to IV by the Global Initiative for Obstructive Lung Disease criteria underwent balloon desobstruction for segmental and subsegmental bronchi by therapeutic bronchoscopy. None of the patie...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
FDA has approved a new device intended to treat breathing difficulty associated with severe emphysema. The approval comes just two weeks after an FDA advisory panel shot down a competing technology targeting the same patient population. The agency approved Pulmonx Inc.'s Zephyr endobronchial valve through the breakthrough device designation, a pathway reserved for devices that provide for more effective treatment or diagnosis of a life-threatening or irreversibly debilitating disease or condition. Devices also must meet one of the following criteria: the device must represent a breakthrough technology; there must be no app...
Source: MDDI - Category: Medical Devices Authors: Tags: Regulatory and Compliance Source Type: news
The FDA approved a new medical device for patients suffering from severe emphysema. The Pulmonx Zephyr Endobronchial Valve is a one-way valve system to be implanted through the airways using a traditional bronchoscope. The valve is integrated into a ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Medicine Thoracic Surgery Source Type: blogs
Abstract Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed. More severe exacerbations should be treated with β-agonists and anticholinergics as...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Eur Respir Rev Source Type: research
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed. More severe exacerbations should be treated with β-agonists and anticholinergics as well as systemic ...
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: COPD and smoking Acute Exacerbations in Pulmonary Medicine Source Type: research
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