The application of transthoracic ultrasound in the detection of lung bullae in lung volume reduction (new technique)

Background
Bronchoscopic lung volume reduction (LVR) is a promising and effective treatment option in severe chronic obstructive pulmonary disease. This study was conducted at Mansoura University Hospitals aiming to assess diagnostic accuracy of transthoracic ultrasound (US) in detection of lung bullae in LVR.


Patients and methods
A total of 22 cases with emphysema were included in the study. They were divided into two groups: the study group included 12 cases who underwent US, whereas the control group included the remaining 10 cases that underwent computed tomography. All cases were subjected to history taking, examination, and routine investigations. Bronchoscopic LVR was performed for all cases.


Results
Postintervention complications such as fever and pain were statistically better in study group, whereas modified Medical Research Council and GOLD did not differ between the two groups before or after treatment. No statistically significant difference was detected between the two groups regarding volumetry, oxygen saturation, 6 min walk test, and pulmonary functions. We found a significant improvement of GOLD classification, modified Medical Research Council, 6 min walk test, forced expiratory volume in 1 s, and forced vital capacity in the study group. Moreover, a significant decrease of oxygen saturation in study group was detected. Volumetry showed a significant decrease in both groups when comparing preintervention and postintervention values.


Conclusion
Transthoracic US is valuable in detection of bullae during LVR, and ethanolamine oleate is safe and effective in LVR with minimal tolerable self-limited complications.