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ADVANCE Discourse: Lab

A Breath of Fresh Air

Published February 22, 2013 3:28 PM by Michael Jones

Writing an opening paragraph can be difficult. I like to take a deep breath before I start. It helps to clear things up, and I can think of a good way to introduce a subject without forcing it. I can’t imagine what it would be like if I couldn’t take that deep breathe to clear my head.

For Emphysema patients, it’s a lot like that -- see how easy that was? -- only all of the time. At the University of Alabama at Birmingham, 55 year-old patient, Perry Waldrop, was recently treated with a late-stage clinical trial procedure using “a foam sealant sprayed into the lungs,” rather than lung volume reduction surgery. According to a Newswise article, the experimental technique involves a “proprietary polymer” that turns into foam in the lungs and, inside of a half-hour, “hardens to a rubbery consistency, blocking off the holes in air sacs and sealing the damaged regions of the lung.” The polymer was compared to a two-part epoxy and is administered with an injection into the lungs.

“The idea behind all lung volume reduction procedures is to reduce the volume in the lung and allow the diaphragm to return to its normal shape and function,” said Mark Dransfield. MD, associate professor in the division of pulmonary, allergy and critical care medicine and lead investigator, in the Newswise story. “We’re looking for a less-invasive way to achieve that goal without the risks inherent in surgery.”

Traditional lung volume reduction surgery involves cutting away the “over-inflated, diseased parts of the lung,” which allows it to return to normal size and subsequently restore normal function in the diaphragm. According to Dransfield, the surgery carries with in a “50-60 percent risk of pulmonary or cardiac complications and a small risk of perioperative death.” The new procedure will hopefully reduce the potential risks associated with surgery while producing the same results.

“We don’t yet know the balance of risks and benefits for this procedure as well as we do for the surgery,” continued Dransfield. “Certainly the hope is the risk will be far lower, and the preliminary data from Europe indicates that that is true. The risk of major cardio- or pulmonary complications is quite low. I think having a safer option that is as effective or almost as effective as surgery will greatly improve our ability to take care of these folks.”

The article went on to note that, so far, the only problem has been a flu-like immune-inflammatory disease that resolves in 2-3 days. The prospect of a less-invasive procedure readily available for emphysema patient, especially those who might not be strong enough to handle a surgery with so many possible problems, is exciting not only to struggling patients, but also US physicians looking for alternative options. 


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