Bronchoscopic lung volume reduction procedures for chronic obstructive pulmonary disease.

Abstract:

BACKGROUND:In the recent years, a variety of bronchoscopic lung volume reduction (BLVR) procedures have emerged that may provide a treatment option to participants suffering from moderate to severe chronic obstructive pulmonary disease (COPD). OBJECTIVES:To assess the effects of BLVR on the short- and long-term health outcomes in participants with moderate to severe COPD and determine the effectiveness and cost-effectiveness of each individual technique. SEARCH METHODS:Studies were identified from the Cochrane Airways Group Specialised Register (CAGR) and by handsearching of respiratory journals and meeting abstracts. All searches are current until 07 December 2016. SELECTION CRITERIA:We included randomized controlled trials (RCTs). We included studies reported as full text, those published as abstract only and unpublished data, if available. DATA COLLECTION AND ANALYSIS:Two independent review authors assessed studies for inclusion and extracted data. Where possible, data from more than one study were combined in a meta-analysis using RevMan 5 software. MAIN RESULTS:AeriSealOne RCT of 95 participants found that AeriSeal compared to control led to a significant median improvement in forced expiratory volume in one second (FEV1) (18.9%, interquartile range (IQR) -0.7% to 41.9% versus 1.3%, IQR -8.2% to 12.9%), and higher quality of life, as measured by the St Georges Respiratory Questionnaire (SGRQ) (-12 units, IQR -22 units to -5 units, versus -3 units, IQR -5 units to 1 units), P = 0.043 and P = 0.0072 respectively. Although there was no significant difference in mortality (Odds Ratio (OR) 2.90, 95% CI 0.14 to 62.15), adverse events were more common for participants treated with AeriSeal (OR 3.71, 95% CI 1.34 to 10.24). The quality of evidence found in this prematurely terminated study was rated low to moderate. Airway bypass stentsTreatment with airway bypass stents compared to control did not lead to significant between-group changes in FEV1 (0.95%, 95% CI -0.16% to 2.06%) or SGRQ scores (-2.00 units, 95% CI -5.58 units to 1.58 units), as found by one study comprising 315 participants. There was no significant difference in mortality (OR 0.76, 95% CI 0.21 to 2.77), nor were there significant differences in adverse events (OR 1.33, 95% CI 0.65 to 2.73) between the two groups. The quality of evidence was rated moderate to high. Endobronchial coilsThree studies comprising 461 participants showed that treatment with endobronchial coils compared to control led to a significant between-group mean difference in FEV1 (10.88%, 95% CI 5.20% to 16.55%) and SGRQ (-9.14 units, 95% CI -11.59 units to -6.70 units). There were no significant differences in mortality (OR 1.49, 95% CI 0.67 to 3.29), but adverse events were significantly more common for participants treated with coils (OR 2.14, 95% CI 1.41 to 3.23). The quality of evidence ranged from low to high. Endobronchial valvesFive studies comprising 703 participants found that endobronchial valves versus control led to significant improvements in FEV1 (standardized mean difference (SMD) 0.48, 95% CI 0.32 to 0.64) and scores on the SGRQ (-7.29 units, 95% CI -11.12 units to -3.45 units). There were no significant differences in mortality between the two groups (OR 1.07, 95% CI 0.47 to 2.43) but adverse events were more common in the endobronchial valve group (OR 5.85, 95% CI 2.16 to 15.84). Participant selection plays an important role as absence of collateral ventilation was associated with superior clinically significant improvements in health outcomes. The quality of evidence ranged from low to high. Intrabronchial valvesIn the comparison of partial bilateral placement of intrabronchial valves to control, one trial favoured control in FEV1 (-2.11% versus 0.04%, P = 0.001) and one trial found no difference between the groups (0.9 L versus 0.87 L, P = 0.065). There were no significant differences in SGRQ scores (MD 2.64 units, 95% CI -0.28 units to 5.56 units) or mortality rates (OR 4.95, 95% CI 0.85 to 28.94), but adverse events were more frequent (OR 3.41, 95% CI 1.48 to 7.84) in participants treated with intrabronchial valves. The lack of functional benefits may be explained by the procedural strategy used, as another study (22 participants) compared unilateral versus partial bilateral placement, finding significant improvements in FEV1 and SGRQ when using the unilateral approach. The quality of evidence ranged between moderate to high. Vapour ablationOne study of 69 participants found significant mean between-group differences in FEV1 (14.70%, 95% CI 7.98% to 21.42%) and SGRQ (-9.70 units, 95% CI -15.62 units to -3.78 units), favouring vapour ablation over control. There was no significant between-group difference in mortality (OR 2.82, 95% CI 0.13 to 61.06), but vapour ablation led to significantly more adverse events (OR 3.86, 95% CI 1.00 to 14.97). The quality of evidence ranged from low to moderate. AUTHORS' CONCLUSIONS:Results for selected BLVR procedures indicate they can provide significant and clinically meaningful short-term (up to one year) improvements in health outcomes, but this was at the expense of increased adverse events. The currently available evidence is not sufficient to assess the effect of BLVR procedures on mortality. These findings are limited by the lack of long-term follow-up data, limited availability of cost-effectiveness data, significant heterogeneity in results, presence of skew and high CIs, and the open-label character of a number of the studies.

authors

van Agteren JE,Hnin K,Grosser D,Carson KV,Smith BJ

doi

10.1002/14651858.CD012158.pub2

subject

Has Abstract

pub_date

2017-02-23 00:00:00

pages

CD012158

issn

1469-493X

journal_volume

2

pub_type

杂志文章,评审
  • Prostaglandins for preventing postpartum haemorrhage.

    abstract:BACKGROUND:Prostaglandins have mainly been used for postpartum haemorrhage (PPH) when other measures fail. Misoprostol, a new and inexpensive prostaglandin E1 analogue, has been suggested as an alternative for routine management of the third stage of labour. OBJECTIVES:To assess the effects of prophylactic prostagland...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000494.pub3

    authors: Gülmezoglu AM,Forna F,Villar J,Hofmeyr GJ

    更新日期:2007-07-18 00:00:00

  • Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant.

    abstract:BACKGROUND:Amniotomy (the deliberate rupture of membranes) was described almost two centuries ago and since then has been used both for induction and augmentation of labour - which are common obstetric practices. Trends have shown a rise in the induction rates over the last decade and data suggest that the rate of labo...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD010626.pub2

    authors: Ray A,Ray S

    更新日期:2014-10-01 00:00:00

  • Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women.

    abstract:BACKGROUND:This systematic review focuses on antiretroviral therapy (ART) for treating human immunodeficiency virus (HIV) infection in ART-eligible pregnant women. Mother-to-child transmission (MTCT) is the primary means by which children worldwide acquire HIV infection. MTCT occurs during three major timepoints during...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008440

    authors: Sturt AS,Dokubo EK,Sint TT

    更新日期:2010-03-17 00:00:00

  • Ready-to-use therapeutic food (RUTF) for home-based nutritional rehabilitation of severe acute malnutrition in children from six months to five years of age.

    abstract:BACKGROUND:Management of severe acute malnutrition (SAM) in children comprises two potential phases: stabilisation and rehabilitation. During the initial stabilisation phase, children receive treatment for dehydration, electrolyte imbalances, intercurrent infections and other complications. In the rehabilitation phase ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD009000.pub3

    authors: Schoonees A,Lombard MJ,Musekiwa A,Nel E,Volmink J

    更新日期:2019-05-15 00:00:00

  • Rapid diagnostic tests for plague.

    abstract:BACKGROUND:Plague is a severe disease associated with high mortality. Late diagnosis leads to advance stage of the disease with worse outcomes and higher risk of spread of the disease. A rapid diagnostic test (RDT) could help in establishing a prompt diagnosis of plague. This would improve patient care and help appropr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD013459.pub2

    authors: Jullien S,Dissanayake HA,Chaplin M

    更新日期:2020-06-26 00:00:00

  • WITHDRAWN: Primary angioplasty versus intravenous thrombolysis for acute myocardial infarction.

    abstract:BACKGROUND:Intravenous thrombolytic therapy is the standard care for patients with acute myocardial infarction, based upon its widespread availability and ability to reduce patient mortality well demonstrated in randomised trials. Despite its proven efficacy, thrombolytic therapy has limitations. Many patients are inel...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001560.pub2

    authors: Cucherat M,Bonnefoy E,Tremeau G

    更新日期:2007-07-18 00:00:00

  • Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke.

    abstract:BACKGROUND:Stroke is one of the leading causes of disability worldwide and aphasia among survivors is common. Current speech and language therapy (SLT) strategies have only limited effectiveness in improving aphasia. A possible adjunct to SLT for improving SLT outcomes might be non-invasive brain stimulation by transcr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD009760.pub4

    authors: Elsner B,Kugler J,Pohl M,Mehrholz J

    更新日期:2019-05-21 00:00:00

  • Antibiotic regimens for the empirical treatment of newborn infants with necrotising enterocolitis.

    abstract:BACKGROUND:Although the exact aetiology of necrotising enterocolitis (NEC) remains unknown, research suggests that it is multifactorial; suspected pathophysiological mechanisms include immaturity, intestinal ischaemia, disruption of intestinal mucosal integrity, formula feeding, hyperosmolar load to the intestine, infe...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007448.pub2

    authors: Shah D,Sinn JK

    更新日期:2012-08-15 00:00:00

  • Oxycodone for cancer-related pain.

    abstract:BACKGROUND:Many people with cancer experience moderate to severe pain that requires treatment with strong opioids, such as oxycodone and morphine. Strong opioids are, however, not effective for pain in all people, neither are they well-tolerated by all people. The aim of this review was to assess whether oxycodone is a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003870.pub6

    authors: Schmidt-Hansen M,Bennett MI,Arnold S,Bromham N,Hilgart JS

    更新日期:2017-08-22 00:00:00

  • Antioxidants for female subfertility.

    abstract:BACKGROUND:A couple may be considered to have fertility problems if they have been trying to conceive for over a year with no success. This may affect up to a quarter of all couples planning a child. It is estimated that for 40% to 50% of couples, subfertility may result from factors affecting women. Antioxidants are t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007807.pub3

    authors: Showell MG,Mackenzie-Proctor R,Jordan V,Hart RJ

    更新日期:2017-07-28 00:00:00

  • Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease.

    abstract:BACKGROUND:The number of surgical techniques for decompression and solid interbody fusion as a treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques is unclear. OBJECTIVES:The goal of this study was to determine which method of anterior cervical interbo...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004958

    authors: Jacobs WC,Anderson PG,Limbeek J,Willems PC,Pavlov P

    更新日期:2004-10-18 00:00:00

  • Transcutaneous carbon dioxide monitoring for the prevention of neonatal morbidity and mortality.

    abstract:BACKGROUND:Carbon dioxide (CO2) measurement is a fundamental evaluation in a neonatal intensive care unit (NICU), as both low and high values of CO2 might have detrimental effects on neonatal morbidity and mortality. Though measurement of CO2 in the arterial blood gas is the most accurate way to assess the amount of CO...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011494.pub2

    authors: Bruschettini M,Romantsik O,Zappettini S,Ramenghi LA,Calevo MG

    更新日期:2016-02-13 00:00:00

  • Topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations.

    abstract:BACKGROUND:Chronic suppurative otitis media (CSOM) causes ear discharge and impairs hearing. OBJECTIVES:Assess topical antibiotics (excluding steroids) for treating chronically discharging ears with underlying eardrum perforations (CSOM). SEARCH STRATEGY:The Cochrane Ear, Nose and Throat Disorders Group Trials Regist...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004618.pub2

    authors: Macfadyen CA,Acuin JM,Gamble C

    更新日期:2005-10-19 00:00:00

  • Pain relief for the removal of femoral sheath in interventional cardiology adult patients.

    abstract:BACKGROUND:There is considerable variation in use of pain relief for managing pain or discomfort of femoral sheath removal. Efficacy of pain relief to promote comfort during this procedure or to reduce the incidence of vascular and procedural complications has not been established. OBJECTIVES:Assess efficacy of pain r...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006043.pub2

    authors: Wensley CJ,Kent B,McAleer MB,Price SM,Stewart JT

    更新日期:2008-10-08 00:00:00

  • Cognitive behavioural therapy plus standard care versus standard care plus other psychosocial treatments for people with schizophrenia.

    abstract:BACKGROUND:Cognitive behavioural therapy (CBT) is a psychosocial treatment that aims to help individuals re-evaluate their appraisals of their experiences that can affect their level of distress and problematic behaviour. CBT is now recommended by the National Institute for Health and Care Excellence (NICE) as an add-o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD008712.pub3

    authors: Jones C,Hacker D,Meaden A,Cormac I,Irving CB,Xia J,Zhao S,Shi C,Chen J

    更新日期:2018-11-15 00:00:00

  • Colloids versus crystalloids for fluid resuscitation in critically ill patients.

    abstract:BACKGROUND:Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids. OBJECTIVES:To assess the effects of colloids compared to crystalloids for fluid r...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000567.pub5

    authors: Perel P,Roberts I

    更新日期:2012-06-13 00:00:00

  • Screening children in the first four years of life to undergo early treatment for otitis media with effusion.

    abstract:BACKGROUND:Otitis media with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioural problems. This condition has a prevalence of about 20% at the age of two years, a time of rapid language development. It is most often asym...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004163

    authors: Butler CC,van der Linden MK,MacMillan H,van der Wouden JC

    更新日期:2003-01-01 00:00:00

  • Supported housing for people with severe mental disorders.

    abstract:BACKGROUND:There has been a significant reduction in the number of people with severe mental illness who spend extended periods in long-stay hospitals. District health authorities, local authorities, housing associations and voluntary organisations are jointly expected to provide support for people with severe mental d...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000453.pub2

    authors: Chilvers R,Macdonald GM,Hayes AA

    更新日期:2006-10-18 00:00:00

  • Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy.

    abstract:BACKGROUND:This is an update of a Cochrane review first published in The Cochrane Library in Issue 3, 2010.For many patients with head and neck cancer, oral nutrition will not provide adequate nourishment during treatment with radiotherapy or chemoradiotherapy due to the acute toxicity of treatment, obstruction caused ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007904.pub3

    authors: Nugent B,Lewis S,O'Sullivan JM

    更新日期:2013-01-31 00:00:00

  • Interventions for promoting habitual exercise in people living with and beyond cancer.

    abstract:BACKGROUND:The beneficial effects of regular exercise for people living with or beyond cancer are becoming apparent. However, how to promote exercise behaviour in sedentary cancer cohorts is not as well understood. A large majority of people living with or recovering from cancer do not meet exercise recommendations. He...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010192.pub2

    authors: Bourke L,Homer KE,Thaha MA,Steed L,Rosario DJ,Robb KA,Saxton JM,Taylor SJ

    更新日期:2013-09-24 00:00:00

  • Nursing record systems: effects on nursing practice and health care outcomes.

    abstract:BACKGROUND:A nursing record system is the record of care planned and/or given to individual patients/clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. OBJECTIVES:To assess the effects of nursing record...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002099

    authors: Currell R,Urquhart C

    更新日期:2003-01-01 00:00:00

  • Coenzyme Q10 for Parkinson's disease.

    abstract:BACKGROUND:A number of preclinical studies in both in vitro and in vivo models of Parkinson's disease have demonstrated that coenzyme Q10 can protect the nigrostriatal dopaminergic system. Some clinical trials have looked at the neuroprotective effects of coenzyme Q10 in patients with early and midstage Parkinson's dis...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008150.pub2

    authors: Liu J,Wang L,Zhan SY,Xia Y

    更新日期:2011-12-07 00:00:00

  • Pharmacotherapy augmentation strategies in treatment-resistant anxiety disorders.

    abstract:BACKGROUND:A large proportion of patients with anxiety disorders fail to respond to first-line medication interventions, despite evidence of the effectiveness of these agents. OBJECTIVES:To assess the effects of medication versus placebo augmentation in the treatment of patients with anxiety disorders who have failed ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005473.pub2

    authors: Ipser JC,Carey P,Dhansay Y,Fakier N,Seedat S,Stein DJ

    更新日期:2006-10-18 00:00:00

  • Calcium channel blockers for people with chronic kidney disease requiring dialysis.

    abstract:BACKGROUND:Calcium channel blockers (CCBs) are used to manage hypertension which is highly prevalent among people with chronic kidney disease (CKD). The treatment for hypertension is particularly challenging in people undergoing dialysis. OBJECTIVES:To assess the benefits and harms of calcium channel blockers in patie...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011064.pub2

    authors: Mugendi GA,Mutua FM,Natale P,Esterhuizen TM,Strippoli GF

    更新日期:2020-10-01 00:00:00

  • Antibiotics versus placebo for acute bacterial conjunctivitis.

    abstract:BACKGROUND:There are concerns about whether antibiotic therapy confers significant clinical benefit in the treatment of acute bacterial conjunctivitis. OBJECTIVES:The aim of this review was to assess the benefit and harm of antibiotic therapy in the management of acute bacterial conjunctivitis. SEARCH STRATEGY:We sea...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001211.pub2

    authors: Sheikh A,Hurwitz B

    更新日期:2006-04-19 00:00:00

  • Nonsteroidal anti-inflammatory drugs for assisted reproductive technology.

    abstract:BACKGROUND:Despite substantial improvements in the success of treatments through assisted reproduction technologies (ART), live birth rates remain constantly low, and practitioners are seeking aetiologic treatments to improve the outcomes.Local inflammatory response is believed to contribute to implantation failure, wh...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007618.pub2

    authors: Nyachieo A,Siristatidis CS,Vaidakis D

    更新日期:2019-10-19 00:00:00

  • Antispasmodics for labour.

    abstract:BACKGROUND:Prolonged labour can lead to increased maternal and neonatal mortality and morbidity due to increased risks of maternal exhaustion, postpartum haemorrhage and sepsis, fetal distress and asphyxia and requires early detection and appropriate clinical response. The risks for complications of prolonged labour ar...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009243.pub3

    authors: Rohwer AC,Khondowe O,Young T

    更新日期:2013-06-05 00:00:00

  • Ionisers for chronic asthma.

    abstract:BACKGROUND:Previous reports have shown that ion content in the air may have an effect on respiratory function. Results from studies which test the efficacy of air ionisers to reduce asthma symptoms are often inconclusive and their use as a treatment for asthma remains debatable. OBJECTIVES:We conducted a systematic re...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002986.pub2

    authors: Blackhall K,Appleton S,Cates CJ

    更新日期:2012-09-12 00:00:00

  • Interventions for emergency contraception.

    abstract:BACKGROUND:Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are available for EC. Information on the comparative effectiveness, safety and convenience of these methods is crucial for reproductive healthc...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001324.pub4

    authors: Cheng L,Che Y,Gülmezoglu AM

    更新日期:2012-08-15 00:00:00

  • Once daily versus multiple daily dosing with intravenous aminoglycosides for cystic fibrosis.

    abstract:BACKGROUND:Patients with cystic fibrosis, who are chronically colonised with the organism Pseudomonas aeruginosa, often require repeated courses of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations. The properties of aminoglycosides suggest that they could be given in higher concentra...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002009

    authors: Tan K,Bunn H

    更新日期:2000-01-01 00:00:00