Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by pathophysiological factors including airflow limitation, hyperinflation and reduced gas exchange. Treatment consists of lifestyle changes, lung rehabilitation and pharmacological therapies such as long acting beta-2-agonists (LABA) and long acting muscarinic antagonists (LAMA). More recently bronchoscopic treatments are emerging for COPD. Among them endobronchial valves (EBV) and endobronchial coils (EBC), next to endobronchial stents, sclerosing agents, targeted lung denervation and liquid nitrogen metered cryospray. In this review we aim to summarize the new emerging bronchoscopic treatments and their effect sizes compared with lung rehabilitation and pharmacological therapies.
Highlights
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by pathophysiological factors including airflow limitation, hyperinflation and reduced gas exchange
In this review we aim to summarize the new emerging bronchoscopic treatments and their effect sizes compared with lung rehabilitation and pharmacological therapies
Most of the evidence has been collected for the use of endobronchial valves and endobronchial coils
Summary
COPD is characterized by a chronic airflow obstruction. Bronchus obstruction and inflammation were the first factors to be treated in COPD. The number of alveoli, the amount of haemoglobin in the blood and the membrane separating air and blood in the alveoli are all influencing gas exchange (Elbehairy et al, 2015; GOLD, 2017; Rodriguez-Roisin et al, 2009). Stem cells, originating from the embryonic mesoderm seem safe to administer. Far they didn't improved gas exchange but where used for their antiinflammatory effects (Weiss, Casaburi, Flannery, LeRoux-Williams, & Tashkin, 2013). Vasodilators do not improve and may even worsen gas exchange (Barbera et al, 1996; Blanco et al, 2013; GOLD, 2017)
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