Effect of Bronchoscopic lung volume reduction on Diaphragmatic Contraction in Patients with severe Emphysema

<bold>Introduction:</bold> Bronchoscopic lung volume reduction (BLVR) with Endobronchial Valves (EBV) has become a treatment option for selected patients with severe emphysema. We assessed its effect on the diaphragmatic contraction. <bold>Methods:</bold> Ultrasound of the diaphragm and pulmonary function testing were performed before (T0) and 3 months after (T1) treatment EBV. Differences in sonographic and pulmonary function parameters between the 2 time points were evaluated with a paired samples t-test. <bold>Results:</bold> 7 patients with a mean age of 65.8±3.2 years were followed for a mean of 98 ± 13 days after BLVR (5 on the right side, 2 on the left). At T1, we observed a significant reduction in total lung capacity (mean difference = 0.31 L, t = 3.51, p = 0.013) and a marginally significant reduction in residual volume (mean difference 0.54 L, t = 2.43, p = 0.051) compared to T0. Diaphragmatic thickness maximum (DTmax) of the right and left hemidiaphragm was significantly decreased, while deep breathing excursion (DE) of the right and left hemidiaphragm was increased after BLVR (Table 1). However, no significant effect on diaphragm thickening fraction and excursion during tidal breathing was noted. <bold>Conclusion:</bold> A significant improvement of maximum diaphragmatic contraction and excursion after placing of EBV was observed, which can add to our comprehension of the positive physiologic effect of BLVR in patients with severe emphysema. <fig><object-id>erj;64/suppl_68/PA4354/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>