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Collateral ventilation measurement using chartis procedural sedation vs general anesthesia

(2019) CHEST. 156(5). p.984-990
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Organization
Abstract
BACKGROUND: Absence of interlobar collateral ventilation is key to successful endobronchial valve treatment in patients with severe emphysema and can be functionally assessed by using the Chartis measurement. This system has been validated during spontaneous breathing, undergoing procedural sedation (PS), but can also be performed under general anesthesia. Performing the Chartis measurement under PS is often challenging because of coughing, mucus secretion, and difficulties in maintaining an adequate level of sedation. The objective of this study was to investigate whether there is a difference in Chartis measurement outcomes between PS and general anesthesia. METHODS: In this prospective study, patients underwent Chartis measurements under both PS and general anesthesia. Study outcomes were Chartis measurement duration, number of measurements, feasibility, and success rate. RESULTS: The study included 30 patients with severe emphysema (mean age, 62 years; median FEV1, 29% of predicted). Chartis measurement duration was significantly longer under PS than under general anesthesia (mean, 20.3 +/- 4.2 min vs 15.1 +/- 4.4 min; P < .001). There was no difference in the number (median [range]) of measurements performed (2 [1-3] for PS vs 1 [1-3] for general anesthesia; P= 1.00). Chartis measurement was more feasible during general anesthesia (median sum of all feasibility scores, 12 [range, 6-26] for PS vs 7 [5-13] for general anesthesia; P < .001). There was no statistical difference in success rate: 77% of PS cases vs 97% of general anesthesia cases (P = .07). CONCLUSIONS: This study found that Chartis measurement under general anesthesia is faster and more feasible to perform compared with performance with PS, without affecting measurement outcomes.
Keywords
LUNG-VOLUME REDUCTION, ENDOBRONCHIAL VALVES, EMPHYSEMA, THERAPY, AGE, Chartis measurement, collateral ventilation, endobronchial valve, treatment, general anesthesia, procedural sedation

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Please use this url to cite or link to this publication:

MLA
Welling, Jorrit, et al. “Collateral Ventilation Measurement Using Chartis Procedural Sedation vs General Anesthesia.” CHEST, vol. 156, no. 5, 2019, pp. 984–90.
APA
Welling, J., Klooster, K., Hartman, J., Kerstjens, H., Franz, I., Struys, M., … Barends, C. (2019). Collateral ventilation measurement using chartis procedural sedation vs general anesthesia. CHEST, 156(5), 984–990.
Chicago author-date
Welling, Jorrit, Karin Klooster, Jorine Hartman, Huib Kerstjens, Ina Franz, Michel Struys, Anthony Absalom, Dirk-Jan Slebos, and Clemens Barends. 2019. “Collateral Ventilation Measurement Using Chartis Procedural Sedation vs General Anesthesia.” CHEST 156 (5): 984–90.
Chicago author-date (all authors)
Welling, Jorrit, Karin Klooster, Jorine Hartman, Huib Kerstjens, Ina Franz, Michel Struys, Anthony Absalom, Dirk-Jan Slebos, and Clemens Barends. 2019. “Collateral Ventilation Measurement Using Chartis Procedural Sedation vs General Anesthesia.” CHEST 156 (5): 984–990.
Vancouver
1.
Welling J, Klooster K, Hartman J, Kerstjens H, Franz I, Struys M, et al. Collateral ventilation measurement using chartis procedural sedation vs general anesthesia. CHEST. 2019;156(5):984–90.
IEEE
[1]
J. Welling et al., “Collateral ventilation measurement using chartis procedural sedation vs general anesthesia,” CHEST, vol. 156, no. 5, pp. 984–990, 2019.
@article{8655074,
  abstract     = {BACKGROUND: Absence of interlobar collateral ventilation is key to successful endobronchial valve treatment in patients with severe emphysema and can be functionally assessed by using the Chartis measurement. This system has been validated during spontaneous breathing, undergoing procedural sedation (PS), but can also be performed under general anesthesia. Performing the Chartis measurement under PS is often challenging because of coughing, mucus secretion, and difficulties in maintaining an adequate level of sedation. The objective of this study was to investigate whether there is a difference in Chartis measurement outcomes between PS and general anesthesia. 
METHODS: In this prospective study, patients underwent Chartis measurements under both PS and general anesthesia. Study outcomes were Chartis measurement duration, number of measurements, feasibility, and success rate. 
RESULTS: The study included 30 patients with severe emphysema (mean age, 62 years; median FEV1, 29% of predicted). Chartis measurement duration was significantly longer under PS than under general anesthesia (mean, 20.3 +/- 4.2 min vs 15.1 +/- 4.4 min; P < .001). There was no difference in the number (median [range]) of measurements performed (2 [1-3] for PS vs 1 [1-3] for general anesthesia; P= 1.00). Chartis measurement was more feasible during general anesthesia (median sum of all feasibility scores, 12 [range, 6-26] for PS vs 7 [5-13] for general anesthesia; P < .001). There was no statistical difference in success rate: 77% of PS cases vs 97% of general anesthesia cases (P = .07). 
CONCLUSIONS: This study found that Chartis measurement under general anesthesia is faster and more feasible to perform compared with performance with PS, without affecting measurement outcomes.},
  author       = {Welling, Jorrit and Klooster, Karin and Hartman, Jorine and Kerstjens, Huib and Franz, Ina and Struys, Michel and Absalom, Anthony and Slebos, Dirk-Jan and Barends, Clemens},
  issn         = {0012-3692},
  journal      = {CHEST},
  keywords     = {LUNG-VOLUME REDUCTION,ENDOBRONCHIAL VALVES,EMPHYSEMA,THERAPY,AGE,Chartis measurement,collateral ventilation,endobronchial valve,treatment,general anesthesia,procedural sedation},
  language     = {eng},
  number       = {5},
  pages        = {984--990},
  title        = {Collateral ventilation measurement using chartis procedural sedation vs general anesthesia},
  url          = {http://dx.doi.org/10.1016/j.chest.2019.07.025},
  volume       = {156},
  year         = {2019},
}

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