Imperial College London
Professor Pallav Shah

ProfessorPallavShah

Faculty of Medicine, National Heart & Lung Institute

Professor of Respiratory Medicine
 
 
 
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Contact

 

+44 (0)20 7351 8021pallav.shah

 
 
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Location

 

Fulham RoadRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Koegelenberg:2022:10.7196/AJTCCM.2022.v28i2.249,
author = {Koegelenberg, CFN and van, Zyl-Smit RN and Dheda, K and Allwood, BW and Vorster, MJ and Plekker, D and Slebos, D-J and Klooster, K and Shah, PL and Herth, FJF and Assembly, on Interventional Pulmonology of the South African Thoracic Society},
doi = {10.7196/AJTCCM.2022.v28i2.249},
journal = {Afr J Thorac Crit Care Med},
title = {Position statement on endoscopic lung volume reduction in South Africa: 2022 update.},
url = {http://dx.doi.org/10.7196/AJTCCM.2022.v28i2.249},
volume = {28},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Chronic obstructive pulmonary disease (COPD) remains one of the most common causes of morbidity and mortality in South Africa. Endoscopic lung volume reduction (ELVR) was first proposed by the South African Thoracic Society (SATS) for the treatment of advanced emphysema in 2015. Since the original statement was published, there has been a growing body of evidence that a certain well-defined sub-group of patients with advanced emphysema may benefit from ELVR, to the point where the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines and the United Kingdom National Institute for Health and Care Excellence (NICE) advocate the use of endoscopic valves based on level A evidence. Patients aged 40 - 75 years with severe dyspnoea (COPD Assessment Test score ≥10) despite maximal medical therapy and pulmonary rehabilitation, with forced expiratory volume in one second (FEV1) 20 - 50%, hyperinflation with residual volume (RV) >175% or RV/total lung capacity (TLC) >55% and a six-minute walking distance (6MWD) of 100 - 450 m (post-rehabilitation) should be referred for evaluation for ELVR, provided no contraindications (e.g. severe pulmonary hypertension) are present. Further evaluation should focus on the extent of parenchymal tissue destruction on high-resolution computed tomography (HRCT) of the lungs and interlobar collateral ventilation (CV) to identify a potential target lobe. Commercially available radiology software packages and/or an endobronchial catheter system can aid in this assessment. The aim of this statement is to provide the South African medical practitioner and healthcare funders with an overview of the practical aspects and current evidence for the judicious use of the valves and other ELVR modalities which may become available in the country.
AU  - Koegelenberg,CFN
AU  - van,Zyl-Smit RN
AU  - Dheda,K
AU  - Allwood,BW
AU  - Vorster,MJ
AU  - Plekker,D
AU  - Slebos,D-J
AU  - Klooster,K
AU  - Shah,PL
AU  - Herth,FJF
AU  - Assembly,on Interventional Pulmonology of the South African Thoracic Society
DO  - 10.7196/AJTCCM.2022.v28i2.249
PY  - 2022///
TI  - Position statement on endoscopic lung volume reduction in South Africa: 2022 update.
T2  - Afr J Thorac Crit Care Med
UR  - http://dx.doi.org/10.7196/AJTCCM.2022.v28i2.249
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35919923
VL  - 28
ER  -
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