Chest
Clinical InvestigationsVOLUME REDUCTION SURGERYHealth-Related Quality of Life Improves Following Pulmonary Rehabilitation and Lung Volume Reduction Surgery
Section snippets
Study Population
A cohort of 19 patients with severe emphysema (FEV1 < 40% predicted) was studied between August 1994 and July 1997. All patients had radiographic evidence of emphysema and hyperinflation without significant bullous disease. Neither a heterogeneous pattern of parenchymal destruction nor disease predominantly confined to the upper lobes, based on quantitative ventilation-perfusion scanning or chest CT scan, was included in the selection criteria. Patients who had evidence of bronchodilator
Results
The cohort of 19 patients (mean age, 61.9 ± 8.5 years) included 13 men and 6 women who underwent a total of 38 procedures. All patients had severe emphysema, with a mean preoperative FEV1 of 0.74 ± 0.26 L (24 ± 9% predicted) and FVC of 2.64 ± 0.91 L (67 ± 23% predicted). All patients reported compliance with their maintenance aerobic exercise regimens. Table 1 displays the patients’ preoperative and perioperative characteristics. Prior to LVRS, 13 patients required supplemental O2 based on
Discussion
HRQL improved after the combination of pulmonary rehabilitation and LVRS in patients with severe emphysema, although each intervention alone was not associated with significant improvements in HRQL. Furthermore, each therapeutic intervention contributed uniquely to the overall improvements in various domains of the SF-36. Pulmonary rehabilitation and LVRS complemented each other to improve both physical and social health status.
Although LVRS significantly improved FEV1 and had the greatest
Conclusion
HRQL provides outcome information that is independent from and complementary to pulmonary function measures. HRQL should be measured directly in patients with emphysema at baseline and after therapeutic interventions. HRQL improves after combined preoperative pulmonary rehabilitation and LVRS in patients with severe emphysema. Each intervention makes a unique and complementary contribution to the overall improvements in HRQL. Increases in lung function explain only part of the improvements in
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Comparison of inspiratory muscle strength training effects between older subjects with and without chronic obstructive pulmonary disease
2011, Journal of the Formosan Medical AssociationPulmonary assessment for general thoracic surgery
2010, Surgical Clinics of North AmericaStaged Lung Volume Reduction Surgery-Rationale and Experience
2009, Thoracic Surgery ClinicsCitation Excerpt :The authors' preliminary results in the relatively small numbers of their population who have undergone their second operation suggest that that this second interventions reverses the decline in specific health status indicators. In the domains of the SF-36 tool concerning social and physical functioning and energy/vitality, previous reports have shown significant improvements up to 2 years after bilateral LVRS, effects that were attributable more to surgery than preoperative rehabilitation.18,19 The authors have found a steady decline in the follow-up measurements of health status after one-stage bilateral LVRS.
Pulmonary rehabilitation in patients undergoing lung-volume reduction surgery
2006, Archives of Physical Medicine and RehabilitationCitation Excerpt :For patients undergoing LVRS, rehabilitation plays an important role in both the presurgical preparation and postoperative recovery. The combination of pulmonary rehabilitation and LVRS provides the greatest benefit for selected patients with severe emphysema, well above the effects of either intervention alone.46 Research is needed to define the exact contributions of pulmonary rehabilitation in other forms of lung disease and for other pulmonary surgical interventions.
SURGERY | Lung Volume Reduction Surgery
2006, Encyclopedia of Respiratory Medicine: Volume 1-4Surgery: Lung Volume Reduction Surgery
2006, Encyclopedia of Respiratory Medicine, Four-Volume Set
Supported in part by National Institutes of Health/National Heart, Lung, and Blood Institute grant HL07633.