{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:18:32Z","timestamp":1759331912703,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Endobronchial valve (EBV) insertion for lung volume reduction is a management option for patients with severe emphysema. One\u2010way valves cause lobar deflation and improve lung function, exercise capacity and quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To retrospectively analyse and compare the outcomes of the first 57 patients treated with EBVs between 2015 and 2021 at the Royal Adelaide Hospital to international standards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical outcomes of forced expiratory volume in 1 s (FEV1), residual volume (RV), treated lobe volume reduction (TLVR) and 6\u2010min walk distance (6MWD) at 3, 6 and 12 months after valve insertion were reviewed against established minimally clinically important differences (MCIDs). Complications and subjective breathlessness measured by Borg scores were also reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010seven patients were included. At 12 months, 77.2% achieved TLVR. FEV1 improved by 170 mL (95% confidence interval (CI): 100\u2013250, <jats:italic>P<\/jats:italic> &lt;\u20090.001), 80 mL (95% CI: 10\u2013150, <jats:italic>P<\/jats:italic> =\u20090.019) and 40 mL (95% CI: \u221260 to 130, <jats:italic>P<\/jats:italic> 0.66) at 3, 6 and 12 months respectively. RV improved by \u2212610 mL (95% CI: \u2212330 to \u2212900, <jats:italic>P<\/jats:italic> &lt;\u20090.0001) at 3 months, \u2212640 mL (95% CI: \u2212360 to \u2212920, <jats:italic>P<\/jats:italic> &lt;\u20090.0001) at 6 months and \u2212360 mL (95% CI: \u221260 to \u2212680, <jats:italic>P<\/jats:italic> =\u20090.017) at 12 months. 6MWD improved by 57.34 m (95% CI: 36.23\u201378.45, <jats:italic>P<\/jats:italic> &lt;\u20090.0001) and 44.93 m (95% CI: 7.19\u201382.67, <jats:italic>P<\/jats:italic> =\u20090.02) at 3 and 6 months. Borg score improved by \u22120.53 (95% CI: 0.11 to \u22121.2, <jats:italic>P<\/jats:italic> =\u20090.11) and \u22120.49 (95% CI: 0.17 to \u22121.15, <jats:italic>P<\/jats:italic> =\u20090.16) at 3 and 6 months. Complication rates aligned with international standards with mucous\/infection (26.3%) and pneumothorax (17.5%) as the most common. Subgroup analysis signalled improved outcomes in patients with heterogeneous emphysema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study represents the first publicly funded Australian analysis of EBVs. The results align with international prospective trials demonstrating improved lung function and exercise capacity. Australians with severe emphysema and gas trapping should be referred to a multidisciplinary centre for consideration of EBVs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16319","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T08:59:42Z","timestamp":1705913982000},"page":"871-881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A 6\u2010year experience of Zephyr endobronchial valves for severe emphysema in an Australian single\u2010centre cohort"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6678-1407","authenticated-orcid":false,"given":"Michael V.","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Thoracic Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arash","family":"Badiei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubertus","family":"Jersmann","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Fon","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Respiratory and Sleep Medicine Queen Elizabeth Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong G.","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Lorraine","sequence":"additional","affiliation":[{"name":"SA Medical Imaging Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phan","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,22]]},"reference":[{"volume-title":"Chronic Obstructive Pulmonary Disease (COPD)","year":"2020","author":"Australian Institute of Health and Welfare","key":"e_1_2_9_2_1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)30221-1"},{"key":"e_1_2_9_4_1","unstructured":"The COPD\u2010X Plan Australian and New Zealand Guidelines for the Management of Chronic Obstructive Pulmonary Disease 2021. 2021."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201803-0590OC"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201607-1383OC"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60001-0"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201707-1327OC"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00161611"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0900928"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507807"},{"key":"e_1_2_9_12_1","unstructured":"GOLD.Global Strategy for the Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease. 2022."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12762-6"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2018.1538780"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0900928"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S103807"},{"key":"e_1_2_9_17_1","unstructured":"TeeV Nguyen P GrosswrD JersmannH Crouch B LorraineB ChewG.The Application of VQ SPECT CT Quantitation in Target Lobe Selection for Endobronchial Valve Lung volume Reduction (EBV\u2010LVR). 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