Endobronchial one-way valves for treatment of persistent air leaks: a systematic review

Respiratory Research

Review

Xian-Tao Zeng¹  Yi Guo¹  Mei Ding²  Ya-dong Gao²  Jiong Yang² 

[1] Center for Evidence-based and Translational Medicine, Zhongnan Hospital of Wuhan University, Donghu Road 169, 430071, Wuhan, People’s Republic of China;Department of Respiratory Medicine, Zhongnan Hospital of Wuhan University, Donghu Road 169, 430071, Wuhan, People’s Republic of China;

关键词: Persistent air leak;    Bronchopleural fistulas;    Alveolar-pleural fistulas;    Endobronchial valve;    Bronchoscopic intervention;   

DOI  :  10.1186/s12931-017-0666-y

 received in 2017-06-03, accepted in 2017-10-18,  发布年份 2017

来源: Springer

【 摘 要 】

Persistent air leak (PAL) is associated with significant morbidity and mortality, prolonged hospitalization and increased health-care costs. It can arise from a number of conditions, including pneumothorax, necrotizing infection, trauma, malignancies, procedural interventions and complications after thoracic surgery. Numerous therapeutic options, including noninvasive and invasive techniques, are available to treat PALs. Recently, endobronchial one-way valves have been used to treat PAL. We conducted a systematic review based on studies retrieved from PubMed, EMbase and Cochrane library. We also did a hand-search in the bibliographies of relevant articles for additional studies. 34 case reports and 10 case series comprising 208 patients were included in our review. Only 4 patients were children, most of the patients were males. The most common underlying disease was COPD, emphysema and cancer. The most remarkable cause was pneumothorax. The upper lobes were the most frequent locations of air leaks. Complete resolution was gained within less than 24 h in majority of patients. Complications were migration or expectoration of valves, moderate oxygen desaturation and infection of related lung. No death related to endobronchial one-way valves implantation has been found. The use of endobronchial one-way valve adds to the armamentarium for non-invasive treatments of challenging PAL, especially those with difficulties of anesthesia, poor condition and high morbidity. Nevertheless, prospective randomized control trials with large sample should be needed to further evaluate the effects and safety of endobronchial one-way valve implantation in the treatment of PAL.

【 授权许可】

CC BY   
© The Author(s). 2017