Bronchopleural fistula (BPF) is a connection between the bronchus and pleural cavity. It is associated with high morbidity and mortality and management of BPF has not been well described in the pediatric population. We describe a 2-year-old girl who presented with fever and increased work of breathing, found to have atypical hemolytic uremic syndrome and Streptococcus necrotizing pneumonia with development of persistent air leak due to bronchopleural fistulas requiring extracorporeal membrane oxygenation (ECMO). Three endobronchial valves were placed with successful resolution of bronchopleural fistulas. She required tracheostomy for chronic respiratory failure and endobronchial valves were eventually removed. Approximately 3.5 months after discharge to acute care rehabilitation, tracheostomy was successfully decannulated. This case highlights the successful use of endobronchial valves for resolution of BPF while on ECMO as well as the importance of further studies on optimal candidates, timing and duration of intervention in addition to sequelae of endobronchial valve placement.
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http://dx.doi.org/10.1177/02676591241268367 | DOI Listing |
Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death globally, characterized by airflow limitation and lung hyperinflation due to emphysema. Bronchoscopic lung volume reduction (BLVR) with endobronchial valves offers a minimally invasive treatment option for emphysema, aiming to reduce lung hyperinflation, thereby improving lung function and exercise tolerance.
Methods: This study evaluated the efficacy of BLVR in a real-life nationwide setting using comprehensive Danish registries.
Breathe (Sheff)
October 2024
Program of Minimally Invasive Thoracic Surgery and New Technologies, Policlinic Hospital, Department of Surgery and Medical Specialties, University of Catania, Catania, Italy.
Volume reduction is a disease-modifying treatment that aims to reshape the diseased lung towards a more normal total lung capacity by removing severely damaged and overinflated lung parenchyma. It is an effective therapeutic strategy in well-selected patients, resulting in improvements in exercise tolerance, lung function, quality of life and survival. The most widespread strategies for volume reduction are either video-assisted thoracoscopic surgery or bronchoscopic lung volume reduction.
View Article and Find Full Text PDFArch Bronconeumol
November 2024
University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, The Netherlands. Electronic address:
Objectives: Little is known about the effect of bronchoscopic lung volume reduction using endobronchial valves (BLVR-EBV) on extrapulmonary manifestations like body composition, muscle function or metabolism. Pulmonary rehabilitation (PR) clearly addresses extrapulmonary manifestations of COPD, including physical inactivity and low muscle mass. However, the added impact of BLVR-EBV+PR remains unknown.
View Article and Find Full Text PDFCurr Opin Pulm Med
January 2025
Department of Medicine, Cardiovascular & Thoracic Surgery, Northwell, New Hyde Park, New York, USA.
Purpose Of Review: Persistent air leaks, defined as an air leak extending beyond 5 days, pose a significant challenge for cardiothoracic surgeons and pulmonologists. Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity.
View Article and Find Full Text PDFRespiration
November 2024
Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Introduction: Endoscopic lung volume reduction (ELVR) with valves is an effective intervention in patients with severe lung emphysema. Two types of valves are established in clinical practice: Zephyr endobronchial valves (EBVs) and Spiration Valve System (SVS). We aimed to compare outcomes and the safety associated with these two types of one-way valves.
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