The influence of lung volume reduction with intrabronchial valves on the quality of life of patients with heterogeneous emphysema - a prospective study.

INTRODUCTION: A heterogeneous emphysema is one of the most severe forms of chronic obstructive pulmonary disease (COPD). In some cases, besides the standard pharmacotherapy, a new treatment option of emphysema can be used - bronchoscopic lung volume reduction (BLVR) with the use of intrabronchial valves. OBJECTIVES: To examine the health-related quality of life (HRQoL) of patients with severe emphysema after intrabronchial valve (IBV) implantation for the treatment of one lung. MATERIAL AND METHODS: From 2011 to 2013 a single centre prospective observational study was performed. The study assessed the effect of the therapeutic BLVR intervention, measured by St. George Respiratory Questionnaire (SGRQ). A statistical analysis by use of Wilcoxon test for dependent variables was performed. RESULTS: Twenty patients were enrolled to the study (mean age 63 ± 10 years), all ex-smokers with tobacco exposure 38 ± 11.3 packyears. After 3 months of IBV treatment the average SGRQ score improved significantly in total (-12.8; p < 0.001) and in domains and the differences were for: "symptoms" (-8.5; p < 0.001), "activity" (-13.9; p < 0.001) and "influence on life"(-13.5; p < 0.002). CONCLUSIONS: The presented study revealed a significant improvement of the quality in the life measured by SGRQ after IBV treatment for heterogeneous emphysema. For the first time our study showed the significant improvement of all three domains of SGRQ after IBV treatment.

[Pulmonary rehabilitation in patients with lung cancer]. / Rehabilitacja oddechowa chorych na raka pluca.

The paper presents current news on the possibilities of conducting rehabilitation of patients suffering from lung cancer. It presents the principles of conducting and contraindications for pulmonary rehabilitation for these patients according to current guidelines of American College of Sport Medicine. The methods of measuring exercise capacity for patients with lung cancer have been discussed. The value of ergospirometrial test with maximum oxygen consumption (VO(2peak)) in predicting not only the survival of patients with lung cancer, but also assessing the possibility of pulmonary rehabilitation programs has been highlighted. In the part devoted to physical training for patients before a surgery for lung cancer, current research results have been presented- these show that even a short, high intensity program of pulmonary rehabilitation for patients with lung cancer before surgery is effective and increases the safety of both- the safety of the surgery and extends survival time after operation for lung cancer. The paper describes difficulties in the implementation of rehabilitation programs after surgery conducted on patients with lung cancer resulting from dysfunction of cardiovascular and muscle atrophy - both skeletal and respiratory. The issue of patients with inoperable lung cancer treated with chemotherapy has been discussed so far in only one paper published in 2007. The results shown in it have been discussed as well. The authors demonstrated a significant improvement in the efficiency of respiratory-circulatory system assessed by six-minute walk test, although the rehabilitation program was graduated by small number of patients (44%). It was noted that patients with inoperable lung cancer now account for a large group of patients who use this type of medical intervention and can significantly improve the quality of life and the method shows positive impact on the survival rate.