{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T23:47:24Z","timestamp":1774914444951,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) has emerged as an important treatment method for patients with severe chronic obstructive pulmonary disease (COPD). Acute exacerbations of COPD (AECOPD) are a frequent complication following BLVR with EBV. However, there is no consensus on the prevention of AECOPD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our study aims to compare the outcomes of different prophylactic measures on the occurrence of AECOPD after BLVR with EBV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicenter, retrospective study of patients who underwent BLVR with EBV at six different institutions. Emphasis was directed towards the specific practices aimed at preventing AECOPD: antibiotics, steroids, antibiotics plus steroids, or no prophylaxis. Subgroups were compared, and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 170 patients were reviewed. The rate of AECOPD was 21.2% for the full cohort. Patients who received prophylaxis had a significantly lower rate of AECOPD compared with those who did not (16.7% vs. 46.2%; <jats:italic>p<\/jats:italic>\u2009=\u20090.001). The rate was lowest in patients who received antibiotics alone (9.2%). There was no significant difference in the rate of AECOPD between patients who received steroids alone or antibiotics plus steroids, compared with the other subgroups. The OR for AECOPD was 4.3 (95% CI: 1.8\u201310.4; <jats:italic>p<\/jats:italic>\u2009=\u20090.001) for patients not receiving prophylaxis and 3.9 (95% CI: 1.5\u201310.1; <jats:italic>p<\/jats:italic>\u2009=\u20090.004) for prophylaxis other than antibiotics alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Administration of antibiotics after BLVR with EBV was associated with a lower rate of AECOPD. This was not observed with the use of steroids or in combination with antibiotics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13450","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T11:46:28Z","timestamp":1633434388000},"page":"43-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prevention of acute exacerbation of chronic obstructive pulmonary disease after bronchoscopic lung volume reduction with endobronchial valves"],"prefix":"10.1111","volume":"16","author":[{"given":"David","family":"Abia\u2010Trujillo","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Sleep Medicine Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandra","family":"Yu Lee\u2010Mateus","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Sleep Medicine Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Garcia\u2010Saucedo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Morristown Medical Center  Morristown New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omran","family":"Saifi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Sleep Medicine Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix J. F.","family":"Herth","sequence":"additional","affiliation":[{"name":"Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R.","family":"Woytanowski","sequence":"additional","affiliation":[{"name":"Respiratory Institute Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ihab","family":"Alshelli","sequence":"additional","affiliation":[{"name":"Respiratory Institute Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajive","family":"Alevas","sequence":"additional","affiliation":[{"name":"Respiratory Institute Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan P.","family":"Uribe Becerra","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Majid","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S.","family":"Edell","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan M.","family":"Dulohery\u2010Scrodin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janani S.","family":"Reisenauer","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiren J.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Jantz","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hawazin K.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine University of Florida  Gainesville Florida 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