COPD

Emphysema

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Emphysema

  • Definition
  1. Chronic Obstructive Pulmonary Disease
  2. "Lung Dry Rot"
    1. Alveolar distention
    2. Destruction of alveolar septae
  • Type
  1. Panacinar
    1. Affects both central and peripheral portions acinus
  2. Centriacinar
    1. Affects primarily Bronchioles and alveolar ducts
    2. Minimal involvement of peripheral acini
  • Symptoms
  1. Scant Sputum production
  2. Exertional Dyspnea
  • Signs
  1. "Pink Puffer"
    1. Thin, dyspneic patient with mild Hypoxia
    2. Contrast with "Blue Bloater" of Chronic Bronchitis
  2. Tachypnea
  3. Prolonged expiration
  4. Hyperresonant chest
  5. Diminished breath sounds
  • Labs
  1. Arterial Blood Gas (ABG)
    1. Slightly decreased arterial pO2
    2. Slightly decreased arterial pCO2
  2. Pulmonary Function Tests
    1. FEV1 reduced
    2. Diffusion capacity (DLCO) reduced
  • Staging
  1. Hyperinflated lungs
  • Management
  1. SEE COPD Management
  2. Lung reduction surgery
    1. Removal of most severely damaged lung (n=20)
    2. Increased mean lung elastic recoil by 27%
    3. Increased FEV1
    4. Increased FVC
    5. Reduced FRC and RV
    6. Improved walking capacity
  3. References
    1. Sciurba (1996) N Engl J Med, 334:1095-9 [PubMed]
  • Complications
  • References
  1. Wilson (1991) Harrison IM, McGraw-Hill, p.1074-82
  2. Martinez (1998) Postgrad Med 103(4):112-25 [PubMed]