Dr Nicholas Hopkinson
Professor Michael Polkey
Dr Matthew Hind
Dr Jenni Quint
Dr Omar Usmani
Dr Sam Kemp
Dr Dennis Carr
Mr Simon Jordan
Download the COPD referral form here
Chronic obstructive pulmonary disease (COPD) is an umbrella term covering chronic bronchitis, emphysema and alpha-one-antitrypsin deficiency, which can be caused by inhaling tobacco smoke or other noxious materials. It is a major cause of ill health in the UK with more than a million people diagnosed in England and Wales. Royal Brompton Hospital offers a world-class, multidisciplinary service to patients in both the local community and across the country.
Within the Trust, we have expertise in non-invasive ventilation (NIV), interventional bronchoscopy and surgical intervention, as well as the systemic manifestations, epidemiology and basic disease mechanisms of COPD.
Lung volume reduction – surgical (LVRS) and bronchoscopic (BLVR)
Lung volume reduction, either surgical or bronchoscopic, has the potential to dramatically improve the condition of people with emphysema. LVRS has a grade A evidence base and is recommended in national and international guidelines for appropriately selected patients with poor exercise capacity and heterogeneous emphysema. LVRS is one of the few interventions that improves survival in COPD. Importantly, the morbidity associated with the procedure is much lower in modern practice than at the time of the National Emphysema Treatment Trial (NETT).
LVRS should be actively considered in all patients who are still limited following pulmonary rehabilitation (Medical Research Council (MRC) dyspnoea score of 4 or 5).
The role of bronchoscopic techniques is evolving. There is now clear evidence that endobronchial valves are effective in selected patients with heterogeneous emphysema (similar criteria to LVRS). The department has been and remains involved in trials of techniques including lung volume reduction coils, bronchoscopic thermal vapour ablation (steam) and endobronchial vagal denervation.
Advanced COPD multidisciplinary team meeting
A multidisciplinary team (MDT) meeting occurs weekly. Patients’ clinical histories, lung function and imaging are reviewed, with input from the thoracic surgical team, radiology and interventional bronchoscopy specialists.
All patients discussed in the MDT are evaluated for their eligibility for possible bronchoscopic therapies.