A feasibility and safety study, of bronchoscopic hot saline ablation (BHSA) of emphysematous lung. A different emphysema therapy

Aim: We evaluated feasibility and safety of relatively simple approach of bronchoscopic lung volume reduction (LVR) technology, independent of collateral ventilation. Description: Six patients with severe upper lobes heterogeneous emphysema, underwent unilateral bronchoscopic instillation of saline thermal energy (temperature 50°C, average volume 130 ml) intending to induce an inflammatory airway and parenchymal and consequently fibrotic response resulting in LVR. Evaluation: Six men and women, with a mean age of 61 years, forced expiratory volume in 1 second (FEV 1 )) of 0.77 +/- 0.17 L (32% of predicted), residual volume (RV) of 4.1 +/- 0.9 L (219% predicted), and gas transfer of 7.8 +/- 2.2 (34% of predicted), underwent unilateral upper lobe treatments. Serious adverse events in 5 included probable bacterial pneumonia and exacerbations of airways disease in 2. Although no important FEV 1 ) or RV changes occurred during 6 months of follow-up, gas transfer improved, 16% to 9.0% +/- 2.1% (38% of predicted), the COPD assessment test (CAT) improved from 22 to 12, Conclusion: These preliminary data on unilateral BHSA therapy confirm feasibility, an acceptable safety profile, and the potential for efficacy of LVR in severe upper lobes emphysematous changes.