Background
Methods
Literature search strategy
Selection criteria
Definitions
Results
Description of included studies
Case reports of PAL treated with endobronchial one-way valves
n/N | Percentage | |
---|---|---|
Demographics | ||
Age (years), median (range) | 57 (18–93) | |
Male sex | 28/51a
| 54.9% |
Female sex | 23/51a
| 45.1% |
Underlying diseases | ||
Lung infection | 11/52 | 21.2% |
Infections of other sites | 1/52 | 2% |
Lung related diseases | 26/52 | 50% |
Chest trauma | 1/52 | 2% |
Cancer | 14/52 | 26.9% |
Systematic diseases | 3/52 | 5.8% |
Causes of air leak | ||
Pneumothorax | 23/52 | 44.2% |
Tension pneumothorax | 6/52 | 11.5% |
Iatrogenic pneumothorax | 6/52 | 11.5% |
Broncho-cutaneous fistula | 1/52 | 2% |
Bronchopleural fistula | 6/52 | 11.5% |
Alveolar-pleural and trans-diaphragmatic fistula | 1/52 | 2% |
Empyema | 9/52 | 17.3% |
Postoperative air leak | 12/52 | 23.1% |
Duration of air leak before endobronchial one-way valve deployment (days),median (range) | 15, (3–2520) | |
Location of air leak | ||
Right upper | 17/52 | 32.7% |
Right middle | 6/52 | 11.5% |
Right lower | 6/52 | 11.5% |
Left upper | 15/52 | 28.8% |
Left lower | 8/52 | 15.4% |
Right main bronchus | 1/52 | 2% |
Left main bronchus | 1/52 | 2% |
Lingual | 5/52 | 9.6% |
Bronchus intermedius | 1/52 | 2% |
Type of endobronchial one-way valve used | ||
Emphasys® | 32/122 | 26.2% |
Spiration® IBV valves | 59/122 | 48.4% |
Zephyr® | 31/122 | 25.4% |
Number of endobronchial one-way valves (per patient),median (range) | 2, (1–8) | |
Duration of air leak after endobronchial one-way valve deployment | ||
< 1 day | 31/50b
| 62% |
1 day≦ ≦2 days | 6/50b
| 12% |
> 2 days | 13/50b
| 26% |
Outcomes | ||
Removal of endobronchial one-way valve | 20/50c
| 40% |
Migration of endobronchial one-way valve | 1/50c
| 2% |
Expectoration of endobronchial one-way valve | 1/50c
| 2% |
Recurrence of air leak | 3/50c
| 6% |
Death not related to deployment of endobronchial one-way valve | 3/50c
| 6% |
Case series of PAL treated with endobronchial one-way valves
First author, year [Article no.] | Publication type | No. of patients, sex(M/F) | Age (years) | Underlying disease (n/N) | Previous interventions (n/N) | Duration of air leak before valve placement | Location of endobronchial one-way valves (n/N) | Type of endobronchial one-way valves; No. of valves used |
---|---|---|---|---|---|---|---|---|
Travaline, 2009 [49] | Retrospective study | 40 (25/15) | Mean ± SD: 60 ± 14 | Cancer (12/40), COPD(12/40), pneumonia (3/40), rheumatoid arthritis(2/40), tuberculosis(1/40), trauma(1/40), aspergilloma(1/40), bronchiectasis (1/40), cor pulmonale(1/40), lung transplantation (1/40), multiple comorbidities (1/40) | chest tube (39/40), Eloesser flap (1/40), Blood patch (3/40), wedge resection (1/40), pleurodesis (1/40) | Median: 20 days; Interquartile range [IQR]: 15 to 45 days | RUL (11/40), RML (3/40), RLL (3/40), LUL (11/40), LLL(5/40), RUL and RLL (1/40), RLL and RML (1/40), RUL and LUL (1/40); | Zephyr®; Mean ± SD: 2.9 ± 1.9 |
Gillespie, 2011 [50] | Retrospective study | 7 (4/3) | Median:58; Range: 17 to 60 | Emphysema (5/7), neoplasia (3/7), pulmonary embolism (2/7), radiation fibrosis (1/7), fungal infection (1/7), empyema (1/7) | surgical interventions (6/7); pleurodesis or pleurectomy (4/7) | Median: 4 weeks; Range: 2 weeks to 5 months | LUL (4/31); LLL (6/31); RUL (7/31); LUL and LLL (14/31) | IBV Valve; Median: 3.5 |
Firlinger, 2013 [51] | Prospective study | 13 | Not specified | Empyema (4/13), pulmonary metastasis (1/13), pleural mesothelioma (3/13), pneumothorax (2/13), lung cancer (2/13), bronchiectasis (1/13) | Chest tube (4/13), lobectomy (3/13), decortication (2/13), radical pleurectomy (3/13), pleurodesis (1/13) | Median: 17 days; Range: 8–31 days | LUL (2/19), LLL (5/19), RUL (10/19), RLL (2/19) | IBV Valve (13/19) and Zephyr® (6/19), Mean ± SD: 1.4 ± 0.7 |
Reed, 2015 [52] | retrospective study | 21 (11/10) | Range: 16 months to 70 years | postoperative (8/21), pneumothorax (11/21), cavitary lung infection (3/21), post-pneumonectomy bronchopleural fistula (2/21), COPD(3/21), Pneumonia(4/21), Rheumatoid lung disease(1/21), ARDS after cardiac surgery (121/), Lung cancer(1/21), Refractory AML(21/), Hypoxic cardiac arrest(121/), Refractory multiple myeloma(1/21) | Chest tube(18/21), Pleurodesis(1/21), Decortication(1/21), intercostal muscle flap coverage (2/21) | Median: 8 days; Mean, 26 days; Range: 1 to 192 days | RUL(20/88), RML(8/88), RLL(8/88), LUL(21/88), Lingula(6/88), LLL(12/88), 2 patients not specified | IBV Valve; Median:3; Range: 1 to 12 |
Dooms, 2014 [53] | prospective study | 10 (9/1) | Median:67; Range: 46 to 75 | Lung cancer (10/10) | Chest tube (10/10), chemical pleurodesis (not specified) | Median: 7 days; Range: 7 to 13 days | RLL (17/42), RUL (10/42), LLL (15/42) | IBV Valve; Median: 4; Range:1 to 9 |
Cordovilla, 2015 [54] | prospective study | 8 (7/1) | Mean: 68.5 Range:28 to 85 | severe pulmonary emphysema(7/8), respiratory failure (5/8), thrombopenia (1/8), ischemic heart disease (1/8) cancer(1/8) | Chest tube (8/8) | Median: 15.5 days | RLL (2/9), Lingula (1/9), RUL (3/9), LUL (1/9), LLL (2/9) | IBV valves(8/9) and Zephyr® (1/9); Median: 2; Range: 1 to 4 |
Hance, 2015 [55] | retrospective study | 14 (10/4) | Mean: 60 | non-small cell lung cancer (4/14), diffuse interstitial lung disease (1/14), cytomegalovirus pneumonitis (1/14), COPD (4/14), histoplasmosis (1/14), pneumonia (1/14), pulmonary nodule (1/14), idiopathic pulmonary fibrosis (1/14), aspergillosis (1/14), cystic fibrosis (1/14), metastatic mesothelioma (1/14), spontaneous pneumothoraxes (3/14) | Chest tube (14/14) | Mean: 21.6 days; Median: 18 days; | Not specified | IBV Valve (14); Median: 2; Range: 1–8 |
Podgaetz, 2015 [56] | retrospective study | 19 (12/7) | Median: 60; Mean:60.4;Range: 38–90 | Osteosarcoma (1/19), COPD (9/19), angiosarcoma (1/19), cryptogenic organizing pneumonia (1/19), pancreatic cancer (1/19), interstitial lung disease (2/19) | Chest tube (19), Chemical pleurodesis (2), Blood patch (1) | Median: 9 days; Mean: 12.8 days; Range: 2–8 days | LUL + lingula (1), RUL (5), LUL (7), RLL (3), RML (1), Lingula (2) | IBV Valve (72); Median: 4; Range: 2–6 |
Bakhos, 2016 [57] | prospective study | 11 (9/2) | Mean ± SD: 65 ± 15; Range: 33–83 | Lung cancer (5/11), mesothelioma (1/11), COPD (6/11), coccidiomycosis (1/11), interstitial lung disease (2/11) | Chest tube (11) | Mean ± SD:16 ± 12 days | RLL (3), RUL (3), LUL (3), RML (1), RUL and RML (1) | IBV Valve; Median: 2; Range: 1–4 |
Podgaetz, 2016 [14] | prospective study | 13 (9/4) | Median: 60; Mean:61.9;Range: 38–90 | Osteosarcoma (1/13), COPD (7/13), Iatrogenic (4/13), Postoperative (2/13), Angiosarcoma (1/13), pancreatic cancer (1/13), cryptogenic organizing pneumonia(1/13) | Chest tube (13) | Median: 9 days; Mean: 14.9 days; Range: 2–88 days | LUL (5), Lingual (2), RUL (4), RLL (2), RML (1) | IBV Valve; Median: 4; Range: 2–6 |
First author, year [Article no.] | Outcome of air leak after endobronchial one-way valve placement (%) | Complications related to endobronchial one-way valves | Removal of endobronchial one-way valves n/N, (%) | Days to endobronchial one-way valves removal (days) | |||||
---|---|---|---|---|---|---|---|---|---|
Complete resolution | Days to complete resolution (days) | Reduction | No change | Recurrence | Not reported | ||||
Travaline, 2009 [49] | 19 patients (47.5%) | Not specified | 18 patients (45.0%) | 2 patients (5.0%) | / | 1 patient (2.5%) | 6 patients: valve expectoration, moderate oxygen desaturation; initial malpositioning of the valve that required redeployment, pneumonia, methicillin-resistant Staphylococcus aureus colonization and one unspecified | 8/40, (20%) | Mean ± SD: 66 ± 53; Range: 7–143 |
Gillespie, 2011 [50] | 6 procedures (75%) | Mean: 5.2 | 2 procedures (25%) | / | 1 patient (14.3%) | / | / | 5/7 (71.4%); | Mean: 37; Range: 14–55 |
Firlinger, 2013 [51] | 10 patients (77%) | 1 | / | / | 3 patients (23%) | / | / | 7/13 (53.8%) | Not specified |
Reed, 2015 [52] | 12 procedures (50%) | Not specified | 10 procedures (42%) | / | / | 2 procedures (8%) | / | 17/21 (81%) | Mean: 57; Range: 1–177 |
Dooms, 2014 [53] | 6 patients (60%) | 1 | 3 patients (30%) | / | 3 patients (30%) | 1 patient (10%) | / | 9/9 (100%) | Median: 23; Range: 14–28 |
Cordovilla, 2015 [54] | 6 procedures (66.7%) | 13 | / | 3 procedures (33.3%) | 1 patient (12.5%) | / | / | 8/8 (100%) | Median: 49; Range: 8–720 |
Hance, 2015 [55] | 8 patients (57%) | Median: 15; Mean: 29 | Not specified | Not specified | 4 patients (29%) | / | 6 patients: persistent air leak (4) and deatha (2) | 3/14 (21.4%) | Mean ± SD: 138 ± 84.0; Median: 153 |
Podgaetz, 2015 [56] | 18 patients (94.7%) | 9 days in patients with lung metastases; 2 days in the rest patients | 1 patientb
(5.3%) | / | / | / | / | 16/19 (84.2%) | Range: 4–6 weeks |
Bakhos, 2016 [57] | 6 patients (54.5%) | Mean: 5; Median: 5.8 | 5 patients (45.4%) | / | 1 patient (9.1%) | / | / | 8/11 (73%) | Mean ± SD: 70 ± 42; Median: 60 days; |
Podgaetz, 2016 [14] | 13 patients (100%) | Mean: 5.5; Median:2 | / | / | / | / | / | 9/13 (69.2%) | 4–6 weeks |