Imperial College London
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DrMatthewHind

Faculty of Medicine, National Heart & Lung Institute

Honorary Research Officer
 
 
 
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m.hind

 
 
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Location

 

Royal BromptonRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Davey:2015:10.1016/S0140-6736(15)60001-0,
author = {Davey, C and Zoumot, Z and Jordan, S and McNulty, WH and Carr, DH and Hind, MD and Hansell, DM and Rubens, MB and Banya, W and Polkey, MI and Shah, PL and Hopkinson, NS},
doi = {10.1016/S0140-6736(15)60001-0},
journal = {Lancet},
pages = {1066--1073},
title = {Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial},
url = {http://dx.doi.org/10.1016/S0140-6736(15)60001-0},
volume = {386},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundLung volume reduction surgery improves survival in selected patients with emphysema, and has generated interest in bronchoscopic approaches that might achieve the same effect with less morbidity and mortality. Previous trials with endobronchial valves have yielded modest group benefits because when collateral ventilation is present it prevents lobar atelectasis.MethodsWe did a single-centre, double-blind sham-controlled trial in patients with both heterogeneous emphysema and a target lobe with intact interlobar fissures on CT of the thorax. We enrolled stable outpatients with chronic obstructive pulmonary disease who had a forced expiratory volume in 1 s (FEV1) of less than 50% predicted, significant hyperinflation (total lung capacity >100% and residual volume >150%), a restricted exercise capacity (6 min walking distance <450 m), and substantial breathlessness (MRC dyspnoea score ≥3). Participants were randomised (1:1) by computer-generated sequence to receive either valves placed to achieve unilateral lobar occlusion (bronchoscopic lung volume reduction) or a bronchoscopy with sham valve placement (control). Patients and researchers were masked to treatment allocation. The study was powered to detect a 15% improvement in the primary endpoint, the FEV1 3 months after the procedure. Analysis was on an intention-to-treat basis. The trial is registered at controlled-trials.com, ISRCTN04761234.Findings50 patients (62% male, FEV1 [% predicted] mean 31·7% [SD 10·2]) were enrolled to receive valves (n=25) or sham valve placement (control, n=25) between March 1, 2012, and Sept 30, 2013. In the bronchoscopic lung volume reduction group, FEV1 increased by a median 8·77% (IQR 2·27–35·85) versus 2·88% (0–8·51) in the control group (Mann-Whitney p=0·0326). There were two deaths in the bronchoscopic lung volume reduction group and one control patient was unable to attend for follow-up asse
AU  - Davey,C
AU  - Zoumot,Z
AU  - Jordan,S
AU  - McNulty,WH
AU  - Carr,DH
AU  - Hind,MD
AU  - Hansell,DM
AU  - Rubens,MB
AU  - Banya,W
AU  - Polkey,MI
AU  - Shah,PL
AU  - Hopkinson,NS
DO  - 10.1016/S0140-6736(15)60001-0
EP  - 1073
PY  - 2015///
SN  - 1474-547X
SP  - 1066
TI  - Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial
T2  - Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(15)60001-0
UR  - http://hdl.handle.net/10044/1/33862
VL  - 386
ER  -
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