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Arschang Valipour - One of the best experts on this subject based on the ideXlab platform.
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endoscopic one way Valve implantation in patients with prolonged air leak and the use of digital air leak monitoring
The Annals of Thoracic Surgery, 2013Co-Authors: Irene Firlinger, Otto-chris Burghuber, Elisabeth Stubenberger, Michael Rolf Müller, Arschang ValipourAbstract:Background Prolonged alveolar-pleural air leaks are associated with increased morbidity and mortality. Endoscopic Valve therapy has been recently introduced as a potential less invasive treatment option. We aimed at quantifying the effects of Valve therapy on air leak flow and clinical outcomes in patients with prolonged air leaks. Methods We report on a series of 16 patients with high comorbidity and evidence of continuous air leak flow in whom chest tubes remained in place for at least 7 days. After identification of the source of the air leak by use of the balloon occlusion technique, endobronchial One-Way Valves were implanted. Digital chest tube monitoring was used to assess air leak flow before, during, and after Valve implantation until chest tube removal. Results The source of the air leak was endoscopically identified in 13 patients (81%). After Valve implantation, air leak flow decreased significantly from 871 ± 551 mL/min to 61 ± 72 mL/min immediately after the intervention ( p p Conclusions Endoscopic implantation of One-Way Valves leads to a significant reduction in air leakage flow and may thus be a valuable treatment option in patients with prolonged air leakage.
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Target lobar volume reduction and COPD outcome measures after endobronchial One-Way Valve therapy
European Respiratory Journal, 2012Co-Authors: Arschang Valipour, Felix J.f. Herth, Gerard J. Criner, Jean Michel Vergnon, Jonathan G. Goldin, Frank C. Sciurba, Armin ErnstAbstract:Introduction: Clinical effectiveness of endobronchial One-Way Valve therapy in patients with emphysema appears to be related to the extent of lobar volume reduction. Methods: Data derived from a multicentre study from 416 patients with severe emphysema (62% male, age 63±7yrs, FEV1 30±8%), who were randomized to Valve therapy (n = 284) or conservative treatment (n = 132), were analyzed. Pulmonary function, exercise capacity, dyspnea scores, and CT analysis of target lobar volume reduction (TLVR) were assessed before and 6 months after Valve therapy. Results: Of patients randomized to the treatment group, 49 (17%) showed > 50% target lobar volume reduction, 57 (20%) demonstrated TLVR between 20% and 50%, and 178 patients (63%) 50% demonstrated greater improvements in lung function parameters, exercise capacity (6-MWT), quality of life (SGRQ) and dyspnea score (mMRC) compared with the other groups. Consequently, BODE index was significantly improved by 1.4±1.8, 0.2±1.3, and 0.1±1.3 points in patients with TLVR > 50%, 20%, and TLVR Conclusions: The extent of lobar volume reduction predicts improvement in BODE index and health outcomes associated with bronchoscopic lung volume reduction using One-Way Valves.
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A leak in the lung: endobronchial One-Way Valve placement as treatment for a persistent bronchopleural fistula
Pneumologie (Stuttgart Germany), 2012Co-Authors: Ulrich Seyfried, Irene Firlinger, E Katz-papatheophilou, Hans Koller, M Reiter, Otto-chris Burghuber, Arschang ValipourAbstract:Patients with bronchopleural fistula are at an increased risk of morbidity and mortality. Treatment of the air leak includes intrathoracic drainage, antibiotic therapy and closure of the fistula, which conventionally has been performed via surgical means. In patients with limited respiratory capacity, less-invasive alternatives are required. Here we report on a 62-year-old patient with underlying severe COPD, who was admitted with a lung abscess and consecutively developed a persistent bronchopleural fistula. Treatment involved antibiotic therapy and endobronchial One-Way Valve placement, which resulted in termination of the air leak and full recovery.
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Das Leck in der Lunge: Bronchoskopische Ventil- implantation zur Behandlung einer persistierenden bronchopleuralen Fistel A Leak in the Lung: Endobronchial One-Way Valve Placement as Treatment for a Persistent Bronchopleural Fistula
2012Co-Authors: Ulrich Seyfried, Irene Firlinger, E Katz-papatheophilou, Hans Koller, M Reiter, Otto-chris Burghuber, Arschang ValipourAbstract:Patients with bronchopleural fistula are at an in- creased risk of morbidity and mortality. Treat- ment of the air leak includes intrathoracic drain- age, antibiotic therapy and closure of the fistula, which conventionally has been performed via surgical means. In patients with limited respira- tory capacity, less-invasive alternatives are re- quired. Here we report on a 62-year-old patient with underlying severe COPD, who was admitted with a lung abscess and consecutively developed a persistent bronchopleural fistula. Treatment in- volved antibiotic therapy and endobronchial one- way Valve placement, which resulted in termina- tion of the air leak and full recovery.
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Endobronchial identification of persistent peripheral bronchopleural fistula with digital chest tube monitoring followed by treatment with endobronchial One-Way Valve implantation
European Respiratory Journal, 2011Co-Authors: Irene Firlinger, Otto-chris Burghuber, Elisabeth Stubenberger, Michael Rolf Müller, Arschang ValipourAbstract:Introduction: Bronchopleural fistula (BPF) is associated with high morbidity and mortality and causes prolonged hospital stay and costs. Surgery remains the treatment of choice, however, many patients are at high risk or unwilling to undergo thoracotomy. Objectives: To present a standardized approach of endoscopic diagnosis and treatment of persistent peripheral BPF. Methods: 10 patients with persistent air leaks (presence of chest tube >7 days) underwent bronchoscopy with balloon occlusion technique and digital monitoring of airflow in order to identify the peripheral source of bronchopleural fistula. Endobronchial One-Way Valve implantation (Spiration Inc., Olympus) was performed on a segmental or subsegmental level to block ventilation to the BPF. Results: Mean chest tube drainage time prior to the intervention was 22±13 days. The source of the BPF was endoscopically identified in all cases. Bronchoscopic Valve implantation (1.6±0.8 Valves per patient) was performed successfully in all patients. Using digital chest tube monitoring air flow immediately decreased from 1026±695ml/min to 56±71ml/min (p < 0,001), indicating successful cessation of the leakage. 2 patients underwent additional chemical pleurodesis. The chest tube was removed 8±5 days after bronchoscopy. There was no evidence of recurrence during a mean follow-up time of 2 months. Conclusion: Using a standardized approach in endobronchial diagnosis followed by endobronchial One-Way Valve implantation results in a high responder rate in patients with peripheral BPF.
Tieqiang Wang - One of the best experts on this subject based on the ideXlab platform.
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anisotropic janus si nanopillar arrays as a microfluidic one way Valve for gas liquid separation
Nanoscale, 2014Co-Authors: Tieqiang Wang, Hongxu Chen, Yang Li, Ye Yu, Shuli Wang, Junhu Zhang, Eugenia Kumacheva, Bai YangAbstract:In this paper, we demonstrate a facile strategy for the fabrication of a One-Way Valve for microfluidic (MF) systems. The micro-Valve was fabricated by embedding arrays of Janus Si elliptical pillars (Si-EPAs) with anisotropic wettability into a MF channel fabricated in poly(dimethylsiloxane) (PDMS). Two sides of the Janus pillar are functionalized with molecules with distinct surface energies. The ability of the Janus pillar array to act as a Valve was proved by investigating the flow behaviour of water in a T-shaped microchannel at different flow rates and pressures. In addition, the One-Way Valve was used to achieve gas–liquid separation. We believe that the Janus Si-EPAs modified by specific surface functionalization provide a new strategy to control the flow and motion of fluids in MF channels.
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Anisotropic Janus Si nanopillar arrays as a microfluidic One-Way Valve for gas–liquid separation
Nanoscale, 2014Co-Authors: Tieqiang Wang, Hongxu Chen, Shuli Wang, Junhu Zhang, Eugenia Kumacheva, Kun Liu, Peihong Xue, Bai YangAbstract:In this paper, we demonstrate a facile strategy for the fabrication of a One-Way Valve for microfluidic (MF) systems. The micro-Valve was fabricated by embedding arrays of Janus Si elliptical pillars (Si-EPAs) with anisotropic wettability into a MF channel fabricated in poly(dimethylsiloxane) (PDMS). Two sides of the Janus pillar are functionalized with molecules with distinct surface energies. The ability of the Janus pillar array to act as a Valve was proved by investigating the flow behaviour of water in a T-shaped microchannel at different flow rates and pressures. In addition, the One-Way Valve was used to achieve gas–liquid separation. We believe that the Janus Si-EPAs modified by specific surface functionalization provide a new strategy to control the flow and motion of fluids in MF channels.
Pamela W. Powell - One of the best experts on this subject based on the ideXlab platform.
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Effects of cuff deflation and One-Way tracheostomy speaking Valve placement on swallow physiology
Dysphagia, 2003Co-Authors: Debra M. Suiter, Gary H Mccullough, Pamela W. PowellAbstract:This study examined the effects of tracheostomy cuff deflation and One-Way speaking Valve placement on swallow physiology. Fourteen nonventilator-dependent patients completed videofluoroscopic swallow studies (VFSS) under three conditions: (1) cuff inflated, (2) cuff deflated, and (3) One-Way Valve in place. Four additional patients with cuffless tracheostomy tubes completed VFSS with and without the One-Way Valve in place. All swallows were analyzed for the severity of penetration/aspiration using an 8-point penetration-aspiration scale. Seven preselected swallow duration measures, extent of hyolaryngeal elevation and anterior excursion, and oropharyngeal residue were also determined. Scores on the penetration-aspiration scale were not significantly affected by cuff status, i.e., inflation or deflation. However, One-Way Valve placement significantly reduced scores on the penetration-aspiration scale for the liquid bolus. Patients who are unable to tolerate thin liquids may be able to safely take thin liquids when the Valve is in place. However, One-Way Valve placement may not be beneficial for all patients. Clinicians who complete VFSS with tracheostomized patients should include several bolus presentations with a One-Way speaking Valve in place before making any decisions regarding the use of the Valve as a means to reduce aspiration.
Bai Yang - One of the best experts on this subject based on the ideXlab platform.
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anisotropic janus si nanopillar arrays as a microfluidic one way Valve for gas liquid separation
Nanoscale, 2014Co-Authors: Tieqiang Wang, Hongxu Chen, Yang Li, Ye Yu, Shuli Wang, Junhu Zhang, Eugenia Kumacheva, Bai YangAbstract:In this paper, we demonstrate a facile strategy for the fabrication of a One-Way Valve for microfluidic (MF) systems. The micro-Valve was fabricated by embedding arrays of Janus Si elliptical pillars (Si-EPAs) with anisotropic wettability into a MF channel fabricated in poly(dimethylsiloxane) (PDMS). Two sides of the Janus pillar are functionalized with molecules with distinct surface energies. The ability of the Janus pillar array to act as a Valve was proved by investigating the flow behaviour of water in a T-shaped microchannel at different flow rates and pressures. In addition, the One-Way Valve was used to achieve gas–liquid separation. We believe that the Janus Si-EPAs modified by specific surface functionalization provide a new strategy to control the flow and motion of fluids in MF channels.
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Anisotropic Janus Si nanopillar arrays as a microfluidic One-Way Valve for gas–liquid separation
Nanoscale, 2014Co-Authors: Tieqiang Wang, Hongxu Chen, Shuli Wang, Junhu Zhang, Eugenia Kumacheva, Kun Liu, Peihong Xue, Bai YangAbstract:In this paper, we demonstrate a facile strategy for the fabrication of a One-Way Valve for microfluidic (MF) systems. The micro-Valve was fabricated by embedding arrays of Janus Si elliptical pillars (Si-EPAs) with anisotropic wettability into a MF channel fabricated in poly(dimethylsiloxane) (PDMS). Two sides of the Janus pillar are functionalized with molecules with distinct surface energies. The ability of the Janus pillar array to act as a Valve was proved by investigating the flow behaviour of water in a T-shaped microchannel at different flow rates and pressures. In addition, the One-Way Valve was used to achieve gas–liquid separation. We believe that the Janus Si-EPAs modified by specific surface functionalization provide a new strategy to control the flow and motion of fluids in MF channels.
Debra M. Suiter - One of the best experts on this subject based on the ideXlab platform.
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Effects of cuff deflation and One-Way tracheostomy speaking Valve placement on swallow physiology
Dysphagia, 2003Co-Authors: Debra M. Suiter, Gary H Mccullough, Pamela W. PowellAbstract:This study examined the effects of tracheostomy cuff deflation and One-Way speaking Valve placement on swallow physiology. Fourteen nonventilator-dependent patients completed videofluoroscopic swallow studies (VFSS) under three conditions: (1) cuff inflated, (2) cuff deflated, and (3) One-Way Valve in place. Four additional patients with cuffless tracheostomy tubes completed VFSS with and without the One-Way Valve in place. All swallows were analyzed for the severity of penetration/aspiration using an 8-point penetration-aspiration scale. Seven preselected swallow duration measures, extent of hyolaryngeal elevation and anterior excursion, and oropharyngeal residue were also determined. Scores on the penetration-aspiration scale were not significantly affected by cuff status, i.e., inflation or deflation. However, One-Way Valve placement significantly reduced scores on the penetration-aspiration scale for the liquid bolus. Patients who are unable to tolerate thin liquids may be able to safely take thin liquids when the Valve is in place. However, One-Way Valve placement may not be beneficial for all patients. Clinicians who complete VFSS with tracheostomized patients should include several bolus presentations with a One-Way speaking Valve in place before making any decisions regarding the use of the Valve as a means to reduce aspiration.
