The importance of patient selection for lung volume reduction

COPD is one of the main causes of morbidity and mortality worldwide. It is a progressive disease for which there is currently no cure, limiting activities of daily living and worsening patients’ quality of life. Emphysema involves the destruction of the lung parenchyma, the main pathogenic manifestation of which is pulmonary hyperinflation, which limits airflow and exercise impairment. In recent years, several treatments have been developed to reduce lung volume and improve ventilatory mechanics. Surgical treatment was used initially, though the high rate of mortality and perioperative complications has caused this treatment be reserved for a select subset of patients. More recently, various endoscopic devices have appeared. There are several ongoing studies aimed at assessing the efficacy and safety of these procedures. Not all patients diagnosed with emphysema are candidates for this treatment and accurate patient selection is essential for achieving positive outcomes.