Javier García López, Paola Benedetti, Luis Puente Maestú and Javier de Miguel Díez.
La volume reduction in chronic obstructive pulmonary disease (EPOC) is “efficient in all its variants”. Do not obstruct, require an exhaustive study of patients who can benefit from these treatments, and how to remove the numbness of the Gregorio Marañón Hospital who participated in a new Jornada Neurology Inter-Hospital of Madrid, organized by Medical Redaction.
Durante el incuentro, auspiciado por la Neumomadrid Foundation and with the collaboration of GSK y Oximesa Nippon Gases, if there is a repercussion on therapeutic options for patients with severe EPOC, which is limited to diarrhea. “The expression we express is a great sensation of air and tenure that breathes in a very superficial form”, he illustrated Paola Benedettispecialist specialist of the Neurology Service of the Hospital Gregorio Marañón, which is centered on the fundamentals and indications of these alternatives.
Mesa de debate about volume reduction in EPOC severo.
The main objective, the expert said, is “add a little more” to the patient, that is, reduce hyperinsuflation enlarging the respiratory mechanism and the function of the diaphragmatic muscle. Additionally, it increases the elastic retraction of the lung, favoring the intermittent gas exchange capacity of the pulmonary vein remaining or restricting the chronic dissemination of oxygen to the aorta.
How to therapy, advertised Beneditti, the reduction in volume has its indications and contraindications. Among the first ones it is possible to find a patient with grave emphysema, with a “very significant” disability or set of determined functional criteria. Among the contraindications, from other fat, enter the bronchiectasis or cancer, as well as persistence of taboo habitat o a tratamiento con prednisona, entre otros.
With all types of pulmonary volume reduction, the specialist is destined the valves for gravity emphysema with integrated cisurasand the steam enfisema grave with cisuras communicadas.
One of the fundamental valves of the valves is subtracted from the neural tube, which is reversible, measures that the steam “is not a reversible option”. At this point, the expert has been quick to point out that the application is technical, not currently possible complications such as dyspnea, fibrosis or aggravated neumonitis.
“Algo imprescindible es la patient selection selectionthe main filter for the indication for these therapies “, the specialist has been removed, who has been hincapié in what hay que”offer a benefit for the loss of risks “. Another important aspect, he added, “is that there is no limit to the age and it does not interfere with the pulmonary transplant”.
Javier García López, Paola Benedetti at the Jornada Interhospital Neumology Hospital.
Experience of Marañón in EPOC volume reduction
At the table, moderately por Luis Puente Maestú, head of the Neumology Service; y Javier de Miguel Díez, head of the Section of the Neurology Service; también has intervened Javier García Lópezsaid the head of the Section of Neurology Service of the center, who relates the experience of the hospital with this technique to a clinical case with which he illustrates how the professional works.
This is how a 71 year old woman, exfumadora, deals with a EPOC de larga duración and that había tends the ingresos in the last three years. With it, and with the patient quality, “be sure to evaluate the exhaust form as possible due to the exclusion”, García explicitly stated, noting that “the patient should consider the risks before deciding to treat them“.
Tras valorar el emphysema in trachea of TCto realize an echocardiogram with what can not be estimated pulmonary hypertension of very specific form, recruits the specialist. At this point, one of the contraindications, pulmonary hypertension, is the uniqueness that exists for the patient, but that “there is more to and more catheterization”, while the few confirmations that it is not moderate or moderate, for what can be done with the treatment.
“As long as it is candida, hay que elegir c lamo la tratamos: si con valvulas o vapor”, relata el specialist. “We always prefer valves because they are reversible and produce complications,” he added. A la patient, recuerda, se le colocaron three millimeter square valves. All of these are only three months beyond what is expected of the consultation. How many times without immediate complications, remember, is the same. Not obstructed, as the high-altitude, patient’s urgency in Refugees toror toric that, when realizing a studio, confirm that you are dealing with a Atelectasia LSDaunque su disnea había mejorado.
Since 2015, the specialist has been remembered, the hospital treated 21 patients trails of coils, valves and steam; with a subjective majority in one in 80 per cent of patients, including 5 years. No obstante, these proceedings are “not for free”, tal and how García was subordinated, because he riesgos associates riesgos. In the experience of the hospital, if you have a case of neomotórax, a massive hemoptysis patients and three patients with severe infections. Not surprisingly, “volume reduction is effective in all its variants”, the neumólogar has been removed, citing the need to carry out an “exhaust study” from each case to the patient’s terrace.
Javier de Miguel Díez, Luis Puente Maestú, Paola Benedetti and Javier García López.
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