{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:04:22Z","timestamp":1787501062819,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic obstructive pulmonary disease (COPD) causes permanent lung damage and is a global health issue. Bronchoscopic Lung Volume Reduction (BLVR) with Zephyr valves has increased COPD treatment choices for individuals with persistent symptoms despite maximal drug therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis evaluated available Zephyr valve data in severe emphysema patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data and methods:<\/jats:title>\n                    <jats:p>We searched Cochrane, PubMed, Google Scholar, Lilacs, and Science Direct extensively and included eight randomized control trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      This meta-analysis comprises 1083 patients 669 Zephyr valve-treated and 414 control. The mean difference in 6-minute walking distance was 37.53 meters (95% CI: 22.14\u201352.90,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Statistically significant improvements were also observed in FEV1 predicted percentage (mean difference: 13.64, 95% CI: 8.51\u201318.77,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and BODE index change (mean difference:\u00a0\u22120.79, 95% CI:\u00a0\u22121.33 to 0.26,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05), mMRC dyspnea scale (mean difference:\u00a0\u22120.27, 95% CI:\u00a0\u22120.55 to 0.02,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) and residual volume (mean difference:\u00a0\u22120.14, 95% CI:\u00a0\u22120.64 to 0.35,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). The quality of life measured by SGRQ also improved significantly (mean difference:\u00a0\u22126.69, 95% CI:\u00a0\u22129.69, \u22124.23,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). While COPD exacerbation rates (OR:1.41, 95% CI: 0.87\u20132.30,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05) and pneumonia rates (OR: 1.72, 95% CI: 0.7\u20134.23,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05) were similar between valve and control groups, pneumothorax risk was significantly higher in the treatment arm (OR: 11.06, 95% CI: 4.10\u201329.80,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). However, there was no significant difference in all-cause mortality between the groups (OR: 1.69; 95% CI: 0.53\u20135.38,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.38).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Zephyr valves may improve lung function, exercise capacity, and quality of life in patients suffering from severe emphysema. However, the increased risk of pneumothorax requires careful patient selection and rigorous post-intervention monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ms9.0000000000003409","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T11:00:25Z","timestamp":1751540425000},"page":"4467-4475","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Endobronchial Zephyr valves for bronchoscopic lung volume reduction for severe emphysema: a systematic review and meta-analysis"],"prefix":"10.1097","volume":"87","author":[{"given":"Yub Raj","family":"Sehdai","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Kentucky, College of Medicine, Bowling Green, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassnain","family":"Awan","sequence":"additional","affiliation":[{"name":"Department of Medicine, M Abdur Rahim Medical College, Dinajpur, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poulomi","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Medicine, North Bengal Medical College and Hospital, Siliguri, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6961-0822","authenticated-orcid":false,"given":"Faisal","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Chittagong Medical College and Hospital, Chattogram, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelmonem","family":"Siddiq","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mansoura University, Mansoura, 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajina","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Medicine, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harendra","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Bronx Health Care, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanskriti","family":"Chapagain","sequence":"additional","affiliation":[{"name":"Department of Medicine, Devdaha Medical College and Research Institute, Bhaluhi, Rupandehi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Khanal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Bronx Health Care, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman","family":"Kadariya","sequence":"additional","affiliation":[{"name":"Department of Medicine, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil","family":"Rayamajhi","sequence":"additional","affiliation":[{"name":"Department of Medicine, UCF\/HCA Florida West Hospital, Pensacola, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimi","family":"Shreshtha","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emilio Aguinaldo College, School of Medicine, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aayush","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Medicine, B.P. Koirala Institute of Health Science, Dharan, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Altaf","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Kentucky, College of Medicine, Bowling Green, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisarfathima","family":"Kazimuddin","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Kentucky, College of Medicine, Bowling Green, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahir Muhammad Abdullah","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Kentucky, College of Medicine, Bowling Green, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Kentucky, College of Medicine, 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