Endobronchial Valve as Treatment of Emphysema Compared with Standard Medical Care: an Evidence-based Case Report

Abstract

Aim: to determine the effectiveness of endobronchial valve placement as treatment of emphysema compared to medical care. Methods: literature searching regarding comparison of endobronchial valve and medical care as treatment of emphysema on PubMed database. The quality of the literatures found was appraised by using critical appraisal sheet from Center of Evidence-Based Medicine, University of Oxford. Results: two randomized controlled trials (RCT) were obtained from literature searching. It was revealed that endobronchial valve placement improved quality of patients with moderate to very severe as compared to medical treatment significantly. However, these significant improvements occurred in patients with high heterogeneity emphysema, complete interlobar fissure, and absence of collateral ventilation. Conclusion: endobronchial valve placement was a more effective treatment in patients with high heterogeneity emphysema, complete interlobar fissure, and absence of collateral ventilation. Assessment by using High Resolution CT-scan (HRCT) must be conducted prior to valve placement to determine suitability of this approach in emphysema patients.