Preliminary results of study of bronchoscopic hot saline ablation (BHSA) treatment, in emphysematous lung disease

Aim: To assesses the beneficial effect of BHSA for endoscopic lung volume reduction, independent to collateral ventilation. Description: We have previously showed the feasibility and the safety of this procedure. Fourteen patients were divided in two groups. 1. Those with very severe non homogenous upper lobes emphysema changes. 2. Those with about 50% emphysematous changes of the upper lobes. In the first group their airways obstruction was more severe compared to the second group. The procedure was performed in the bronchoscopy suit under moderate sedation. The saline was warmed and instilled to the lung at 55oC. The amount of saline was based relatively to TLC and it range 80-160 ml. No major side effects were observed. Evaluation: There was no significant difference between the groups regarding age, sex. The group with severe emphysematous changes (1) demonstrated a short lasting of clinical improvement that after 3 month returned to baseline. Group 2. showed improvements in COPD assessment test (CAT), significant increase in 6 minute walking distance, and reduction in air trapping. Conclusion: Unilateral BHSA treatment of patients with severe COPD-Emphysema of upper lobe that include also normal lung according imaging is beneficial procedure for them, whereas those with very severe emphysematous changes the procedure is not effective.