Pulmonary emphysema


Pulmonary emphysema

Description of pulmonary emphysema

It is an irreversible, progressive destruction of lung tissue.Consequently disappearance of lung tissue formed thin-walled “cysts” filled the air. These are called bulls and accordingly also called bullous emphysema. This disease often occur naturally, but as part of Chronic Obstructive Pulmonary Disease, which is characterized Emphysema, along with chronic bronchitis (chronic bronchitis).

The emergence of emphysema is associated with impaired balance between system damaging proteins of the human body and the protective system of the body proteins. If outweigh the first system leads to the destruction of the alveoli. The cause may be adverse environmental effects (especially smoking) or inadequate protective function of the organism (eg. Α1 antitrypsin deficiency). α1 antitrypsin protein that blocks the body degrading enzymes other body proteins. The damage to the lungs may also contribute to bronchial obstruction, which increases pressure in the alveoli and damaging their walls.

Emphysema can be classified according to the length of the formation of the chronic and acute andcongenital or acquired. Further splits according to generalized lesion (both lungs), one-sidedand localized. The most serious, while the most common form of emphysema, obstructive emphysema.

Risk factors for pulmonary emphysema

Definite risk factor is smoking, which supports the destruction of lung tissue. It is important toavoid both active and passive smoking. This system supports the vice enzyme that breaks down proteins and inhibits the body opposite the enzymes that protect the body proteins. Furthermore Smoking promotes development of chronic bronchitis, resulting in gradual deterioration and narrowing of the bronchi. This limits the normal flow of air in the lungs and increases the pressure, which can mechanically “tear” pulmonary emphysema and amplifies. Another risk factor is acongenital deficiency of α1 antitrypsin, a protein that blocks the body’s enzymes degrade other proteins. It’s actually such a protective factor that can be weakened, for example, smoking or he has given little patient from birth (congenital deficiency). Emphysema may also arise after the partial removal of the lungs (removal lobe) when the remaining portion of the lung parenchyma expands and fills the chest cavity. As a result of this, however, is stretched cracking septa between alveoli and pulmonary emphysema formation kompenzatorního.

Prevention of pulmonary emphysema

It is essential not to smoke at all, or at least stop smoking. Most patients with emphysema suffer simultaneously also obstructive bronchitis (bronchitis, which participates in the formation of emphysema). Therefore, such diseases gave the name of chronic obstructive pulmonary disease(COPD). It is subdivided into two clinical parts according to whether the prevailing emphysema or chronic bronchitis. However, it is important precipitating factor in chronic obstructive pulmonary disease, which is smoking in up to 80%. Furthermore it is recommended to avoid inhalation of various toxic compounds which can irritate the respiratory system and our cause respiratory bronchiolitis (inflammation of the bronchioles). As a risk factor is also considered age. The older a person is, the greater the chance that ill pulmonary emphysema. More frequently affected than women. In developing this disease also plays the role of a genetic component and bronchial reactivity.

Signs and symptoms of pulmonary emphysema

The most common symptom is shortness of breath (breathing increased activity due to lack of oxygen in the body). Another manifestation may be coughing and wheezing. Often the patients initially found decreased exercise tolerance, meaning that the earlier and more easily tired. A typical feature is a barrel-shaped chest position. The chest is also in a puff of thick (barrel-shaped) and it looks like when you inhale. This is the result of the inability to exhale all the airbecause when it collapsed bronchioles and small bronchi. The patient tries to breathe more power, the more the collapse and air trapped in the lungs. Therefore, we can sometimes see patients when exhaling and have pursed lips. This helps them to keep airway more pressure and they many not collapse. In later stages, patients present cyanosis (bluish skin, lips, mouth and nail beds).Sometimes we discover at the hands of the patient clubbing (last article deformity of the nail bed and toes). On physical examination, the doctor discovers excessively sounding percussion (Hypersonic) on the chest. When listening with a stethoscope is respiratory depression. Patients suffering from polycythemia oxygen deficient (excessive amount of red blood cells).

Diagnosis of pulmonary emphysema

The initial physical examination and a history list, which is a set of data on diseases resulting in the patient and his relatives and other information. Another examination is a standard chest X-ray,which is no longer able to catch emphysema. Then, very often they carried out functional tests. An example is spirometry, which will show us the functional lung capacity (how much air the lungs can hold) the volume of air you inhale and exhale, and how much gas remains in the lungs after exhalation. It is also important information about the speed of airflow in the lungs. The same can be done and after exercise. Another imaging technique is computed tomography (CT), which makes for smaller especially congenital emphysematous bullae. If a positive family history, the patient is examined for genetically α1 antitrypsin deficiency. Commonly patients bled to detect any signs of inflammation or the amount of dissolved blood gases (oxygen and carbon dioxide).

Treatment of pulmonary emphysema

The first and absolutely essential step is an absolute ban on smoking. It is not a treatment, but you can not deny the significant therapeutic effect. There are also medicines that are used bronchodilators, which widen the bronchi. The most commonly used drug salbutamol whose company name as Ventolin. If this is not enough, the addition of other drugs of bronchodilator (theophylline, ipratropium bromide, etc.). Furthermore, it is an important anti-infective therapy, often administered antibiotics. If emphysema associated with bronchitis, taking steroids (e.g. spray).When significant dyspnea is administered oxygen therapy. An important part of the therapy are alsobreathing exercises under the guidance of an experienced physiotherapist. For patients with advanced emphysema or if bullae which threatens to burst, is indicated surgical therapy that the patient relieved to improve its physical condition and acts also as a prevention against pneumothorax (= accumulation of gas in the pleural cavity). In very severe cases, it is rarely possible to perform a lung transplant. The patient, however, must renounce smoking, so he could be given to a new body.

How can I help treat pulmonary emphysema

The most important thing is to quit smoking and lead a healthy life, if possible. If the person already sick need regular exercise throughout the body, including breathing exercise that teaches the patient physiotherapist. Furthermore, the patient should avoid respiratory infections,it is warmly dressed, avoiding infectious collectives, especially during seasonal diseases, ensure preventive vaccination etc. is also essential to follow the advice and recommendations of doctors.

Complications pulmonary emphysema

Essential complications of emphysema is bursting bulls and the emergence of pneumothorax. Air gets into the thoracic cavity, which is normally negative pressure, this results in a collapse of the lungs. The next time you inhale is already not developed lungs and is excluded from the activities.Pneumothorax clinically apparent sudden chest pain and shortness of breath with follow-up. If pneumothorax is small for his treatment in just a few days of bed rest, with possible oxygen therapy. While severe impairment is indicated thoracic drainage, or at least a single sucking air. In case of failure of all methods is on the agenda surgical intervention. Surgically are also being addressed lung bullae, which threatens its rupture as prevention of pneumothorax.

In the final stage of this disease threatens serious respiratory insufficiency. The patient is unable to breathe all the carbon dioxide and obtain needed oxygen. Resulting in narrowing of pulmonary arteries and right heart congestion and vice versa extension cerebral vessels, which causes increase in intracranial pressure with symptoms of disorientation and headache. As we have already mentioned, complications of pulmonary emphysema may be right heart failure. It is caused by narrowing of the pulmonary arteries due to lack of oxygen and others, many vessels destroyed dwindling partitions between the pulmonary alveoli. This results in increasing the resistance of blood flow and the right ventricle, which pumps blood to the lungs is more stressed. First the heart adapts and operates with greater intensity. Later, however, it is constant overloading affected and may start to fail, which greatly worsens the prognosis of the patient.

Other names: Pulmonary emphysema, chronic obstructive disease, hyperinflation

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