Pathophysiology: Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking. If you smoke, quitting can help prevent you from getting the disease. If you already have emphysema, not smoking might keep it from getting worse. Treatment is based on whether your symptoms are mild, moderate or severe. Treatments include inhalers, oxygen, medications and sometimes surgery to relieve symptoms and prevent complications. Statistics: Emphysema evidenced visually by HRCT was present in 43% of the subjects. Using a 0-5 grade scale (0=normal finding; 5=emphysema in most slices), the degree of emphysema was almost exclusively 3-4. The type of emphysema was distributed as centrilobular emphysema predominant in 43.5%, paraseptal emphysema predominant in 43.5%, and as an equal mixture of these types in 13%. The presence of emphysema did not differ between the group of smokers with lower normal values of lung function and the rest of the smokers. Smokers with emphysema had significantly lower BMI than those devoid of emphysema, 24 and 27 respectively (p<0.0011). There was a high occurrence of visual emphysema in middle-aged smokers with normal lung function.
Treatment: Depending upon the severity of your symptoms, your doctor might suggest: • Bronchodilators. These drugs can help relieve coughing, shortness of breath and breathing problems by relaxing constricted airways, but they're not as effective in treating emphysema as they are in treating asthma or chronic bronchitis. • Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays may help relieve shortness of breath. Prolonged use may weaken your bones and increase your risk of high blood pressure, cataracts and diabetes. • Antibiotics. If you develop a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate. Therapy • Pulmonary rehabilitation. A pulmonary rehabilitation program can teach you breathing exercises and techniques that may help reduce your breathlessness and improve your ability to exercise. • Nutrition therapy. You'll also receive advice about proper nutrition. In the early stages of emphysema, many people need to lose weight, while people with late-stage emphysema often need to gain weight. • Supplemental oxygen. If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and when you exercise may provide some relief. Many people use oxygen 24 hours a day. It's usually administered via narrow tubing that fits into your nostrils. Surgery Depending on the severity of your emphysema, your doctor may suggest one or more different types of surgery, including: • Lung volume reduction surgery. In this procedure, surgeons remove small wedges of damaged lung tissue. Removing the diseased tissue helps the remaining lung tissue expand and work more efficiently and helps improve breathing. • Lung transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.