الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Lung hyperinflation or air-trapping due to destruction of lung elastic tissues represents the principal defect in pulmonary emphysema. Conventional medical treatment (bronchodilators and anti-inflammatory medications) does not influence the morphological configuration of the diseased lung, which becomes an independent pathophysiological factor over the course of the disease. Loss of elastic recoil in pulmonary emphysema can be corrected by lung volume reduction through resecting, collapsing or obliterating areas of destroyed lung making a poor contribution to gaseous exchange. The remaining lung fills the space restoring elastic recoil, reducing dynamic airway closure and gas trapping. The resulting decrease in residual volume returns the diaphragm to a favorable position for efficient ventilation. This pre/post clinical interventional study was conducted at interventional pulmonology unit of chest medicine department, Mansoura University Hospitals after approval from Mansoura university institutional research board (IRB). 19 pulmonary emphysema patients (mean age of 54 (SD: 7.5)) were enrolled at this pre/post interventional study. Nearly 79% of the studied patients were males and 68.4% were ex-smokers. The studied patients received one session of bronchoscopic instillation of Ethanolamine Oleate. The left upper lobe was the most common injected site Although there was statistical significant improvement of mMRC dyspnea scale (p; 0.002) after one month of bronchoscopic Ethanolamine Oleate instillation, this value of no clinical significance and failed to meet MCID criteria (∆mMRC <1 point). 10 patients showed lower mMRC one month after Ethanolamine Oleate instillation than before instillation, while 9 patients showed the same results, However, there was statistically significant improvement in 6MWD distance and desaturation after bronchoscopic Ethanolamine Oleate instillation (p; 0.001) and meet MCID criteria (6MWD distance (Δ = + 25.38)). As regard pulmonary function tests, there were statistical significant improvement in FEV1%, DLCo% and RV/ TLC% after bronchoscopic Ethanolamine Oleate instillation (p; 0.03 and ≤0.001 respectively) but no significant improvement in FVC% was detected (p=0.1). FEV1 (Δ = +2% and 10ml), RV\TLC% (Δ = −31%), FVC% (Δ = +1.5%) and DLCo% (Δ = +6.46%). FEV1 improvement failed to meet MCID criteria. Conclusion: This study showed statistical improvement in exercise tolerance and pulmonary function tests in pulmonary emphysema patients after bronchoscopic instillation of Ethanolamine Oleate. However, clinical improvement was detected only in exercise tolerance. This study showed that bronchoscopic instillation of Ethanolamine Oleate is safe.