EMPHYSEMA

  •  Emphysema is a type of COPD (chronic obstructive pulmonary disease).

  • Emphysema is defined as enlargement of the air spaces distal to the terminal bronchioles, with destruction of their walls of the alveoli.
  • Blebs in respiratory airways 
  • Type 1 respiratory failure
  • respiratory alkalosis

Air trapping on exhalation and amount of air going out is lesser

↓

So FEV1 less than normal 

↓

On giving Salbutamol, no change in FEV1
So it is a Non Reversible Air flow obstruction

On examination :


  • Breathlessness
  • Exercise intolerance
  • Tachypnoea
  • Accessory muscle working excessively
  • Barrel shaped chest ( anterioposterior diameter > Transverse diameter)
  • Liver palpable (due to hyperinflation of lungs)

work up :

  • Spirometry
  • HRCT (investigation of choice) - Blebs
  • ABG - Type 1 Respiratory failure (Respiratory Alkalosis)
  • DLco - Diffusion capacity of lung for carbon monoxide - decreased
  • chest x-ray
- Flattening of diaphragm
- Tubular heart
- Lungs appear more black than normal
- Vascular markings present

Treatment :

QUIT SMOKING - Nicotine buccal spray/varenicline (α2β2 partial agonist of nicotine receptor)
- Video assisted thoracoscopic surgery - Bullectomy

TOC (Treatment of choice) - Lung Transplantation



 

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