Bronchoscopic Lung Volume Reduction in COPD Patients with Silver Nitrate Orhistoacryl

Background: Lung volume reduction means reduction of part of the lung which is physiologically nonfunctional and has no role in the normal process of gas exchange between air in the alveoli and blood in the alveolar capillaries. This part of lung may also compress and affect the function of the normal functioning lung tissue adjacent to it. Many bronchoscopic lung volume reduction materials used to reduce lung volume in patients with emphysema such as one-way valves, coils plugs/occluders/blockers, and other biological lung volume reduction maneuvers.

Purpose: To evaluate feasibility, efficacy and safety of silver nitrate or Histoacryl in bronchoscopic lung volume reduction in COPD patients.

Materials and Method: The present study included 30 patients subjected to full history taking, full clinical examination, chest x-ray & HRCT chest, spirometry, lung volumes, 6- minute walk test, diaphragmatic excursion by chest ultrasound, Fiberoptic bronchoscopy and BLVR with application of silver nitrate or Histoacryl.

Results: In our study, lung volume reduction was associated with improvement after 3 months in FEV1 ((8.55 ± 12.38 %) with Histoacryl VS (10.61 ± 11.50 %) with silver nitrate), 6 MWT (61.94 ± 37.45 %) with Histoacryl VS (48.08 ± 33.68 %) with silver nitrate), diaphragmatic excursion (48.03 ± 29.12 %) with Histoacryl VS (61.31 ± 26.15 %) with silver nitrate) , RV ((41.50 ± 21.58 %) with Histoacryl VS (40.98 ± 18.12 %) with silver nitrate), TLC ((37.12 ± 16.17 %) with Histoacryl VS (37.37 ± 18.74 %) with silver nitrate), MMRC ((22.78 ± 9.69 %) with Histoacryl VS (27.78 ± 8.72%) with silver nitrate ) and CAT ((15.97 ± 7.08 %) with Histoacryl VS (16.17 ± 5.94 %) with silver nitrate).

Conclusion: Bronchoscopic Lung Volume Reduction With Silver Nitrate solution 0.5% or Histoacryl may be a safe, cheap and effective therapy in patients with advanced emphysema.