title: Noninvasive ventilation and lung volume reduction.
abstract: As parenchymal lung disease in chronic obstructive pulmonary disease becomes increasingly severe there is a diminishing prospect of drug therapies conferring clinically useful benefit. Lung volume reduction surgery is effective in patients with heterogenous upper zone emphysema and reduced exercise tolerance, and is probably underused. Rapid progress is being made in nonsurgical approaches to lung volume reduction, but use outside specialized centers cannot be recommended presently. Noninvasive ventilation given to patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease reduces mortality and morbidity, but the place of chronic non-invasive ventilatory support remains more controversial.
authors: Lane Fox Clinical Respiratory Physiology Group, Guy's & St Thomas' NHS Foundation Trust, London, UK.
authors: Patrick Brian
authors: PB
authors: Murphy
authors: NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, Imperial College London, London, UK.
authors: Zaid
authors: Z
authors: Zoumot
authors: NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, Imperial College London, London, UK. Electronic address: m.polkey@rbht.nhs.uk.
authors: Michael Iain
authors: MI
authors: Polkey
mesh_terms: D001999:Bronchoscopy; D006801:Humans; D006935:Hypercapnia / Q000628:therapy; D008168:Lung / Q000503:physiopathology / Q000601:surgery; D063087:Noninvasive Ventilation / Q000379:methods; D011013:Pneumonectomy / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery / Q000628:therapy*; D011656:Pulmonary Emphysema / Q000601:surgery*
keywords: Collateral ventilation; Emphysema; Lung volume reduction surgery; Noninvasive ventilation