Expert statement: pneumothorax associated with endoscopic valve therapy for emphysema--potential mechanisms, treatment algorithm, and case examples.
The use of endoscopically placed unidirectional valves for the treatment of emphysema is increasing. With better patient selection, there is also an increased likelihood of complications associated with the procedure, such as postprocedural pneumothorax. There is, however, little evidence of pneumothorax management in patients with severe COPD and emphysema. This report describes an expert recommendation that has been developed to outline pneumothorax management after valve placement to inform physicians and patients of the risk-benefit profile and to assist them in decision making. Skilled and aggressive pneumothorax management is necessary in this patient population, and by following these recommendations traumatic scenarios, prolonged drainage, extended hospitalizations, and/or surgery might be avoided in many cases.
Department of Respiratory and Critical Care Medicine, Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria.
Arschang
A
Valipour
Dirk-Jan
DJ
Slebos
Hugo G
HG
de Oliveira
Ralf
R
Eberhardt
Lutz
L
Freitag
Gerard J
GJ
Criner
Felix J F
FJ
Herth
D000465:Algorithms; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods; D019468:Disease Management; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods