Assessment of the lung function using impulse oscillometry before and after bronchoscopic lung volume reduction

Abstract

Chronic Obstructive Pulmonary Disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients. (125) Emphysema is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls without obvious fibrosis. Emphysema, or destruction of the gas exchanging surfaces of the lung (alveoli), is a pathological term that is often (but incorrectly) used clinically and describes only one of several structural abnormalities present in patients with COPD. (126) Lung volume reduction surgery (LVRS) is a surgical procedure performed to remove diseased, emphysematous lung tissue. Lung volume reduction surgery, or LVRS, can improve the quality of life for certain COPD and emphysema patients. Parts of the lung that are particularly damaged by emphysema are removed, allowing the remaining, relatively good lung to expand and work better. 137 Impulse oscillometry is a noninvasive, rapid, safe and validated technique that measures respiratory impedance that is used as an indicator of lung function. This is the first study to use a biological material (histoacrayl) and to use the IOS as a tool to measure the P.F.T after bronchoscopic lung volume reduction. The current study was conducted at Kobri El-koba Military Hospital from July, 2014 to April, 2015 to to assess of the lung function using impulse oscillometry before and after bronchoscopic lung volume reduction using histoacrayl. Thirty male patients included in this study from July, 2014.Their age ranging from 35 to 68 with mean age 62 years old (± 7.7), with a smoking index of (435± 55) pack/year. The most common co-morbidity was IHD 3(10%).The patients were divided in 2 groups: group A: