Biological Lung Volume Reduction (BLVR)

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1.Introduction

COPD is the common chronic disease with the high rate of morbidity and mortality. It is estimated that COPD will become the third leading cause of death in 2020.1 The most noticeable symptoms of this disease are productive cough, shortness of breath and limited exercise capacity. While the main obvious pathophysiological hallmark of COPD is Expiratory Flow limitation which causes acute dynamic lung hyperinflation, dyspnea is increasingly implicated as the primary symptom causes exercise limitation and skeletal muscle deconditioning as a result of avoidance activity. Hyperinflation, refers to an increase in lung volume above the resting volume due to air trapping, is the crucial consequence of mechanical restriction of this
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3.3. Biological Lung Volume Reduction (BLVR)
BLVR is a novel method of lung volume reduction involves administration of biologic agent at emphysematous bronchi to collapse the hyperinflated parenchyma and shrink the damaged part because of stimulating an inflammatory response. The biologic complex which is combination of chondroitin sulfate and poly- l -lysine is delivered in a fibrin vehicle simultaneously with a thrombin solution via a dual lumen catheter in the flexible bronchoscope where the component fills alveoli and blocks collateral ventilation.18
Conclusion
It can be concluded that the most beneficial effect of pharmacological and non-pharmacological method of lung volume reduction can be seen in severe COPD patients especially in those with dynamic hyperinflation that plays a central role in COPD exercise limitation and dyspnea. Furthermore, most of these methods cause a reduction in airway resistance as well as a decrease in pulmonary air trapping and an increase in IC that consequently improve exercise capacity and relieve dyspnea at rest and exercise. In spite of many studies in different methods of lung volume reduction, there are still some unanswered questions that should be debated. One significant point is about the long-term outcome of these therapeutic interventions as a sustained effect on reducing DH and improving dyspnea and exercise

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