Emphysema Of The Lungs - What Is It, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-17 02:10

Emphysema of the lungs

Emphysema of the lungs is a condition characterized by expansion of the chest wall. The name of this chronic disease comes from the word emphysao - to inflate (Greek). As a result of the disease, the septa between the alveoli are destroyed and the end branches of the bronchi expand. The lungs inflate, their volume increases, and air voids form in the tissue of the organ. This leads to the expansion of the chest, acquiring a characteristic barrel-shaped shape.

The mechanism of lung damage in emphysema:

1. The alveoli and bronchioles are stretched and doubled.
2. The walls of the vessels become thinner, stretching of smooth muscles occurs. Due to the desolation of the capillaries, nutrition in the acinus is disturbed.
3. Excess air in the alveolar lumen is not oxygen, but an exhaust gas mixture with a high carbon dioxide content. Due to a decrease in the area of formation of gas exchange between blood and air oxygen, oxygen deficiency is felt;
4. Healthy lung tissue is exposed to pressure from the enlarged areas, ventilation of this organ is impaired with the appearance of shortness of breath and other symptoms of the disease.

5. It leads to an increase in intrapulmonary pressure, which causes compression of the pulmonary arteries. At the same time, the right parts of the heart experience a constant increased load to overcome this pressure, which underlies the concomitant reconstruction of the heart muscle in the form of a chronic cor pulmonale;
6. Causes oxygen starvation of tissues and signs of respiratory failure.

Speaking about the pathogenesis of pulmonary emphysema in the classical version, it can be characterized as follows: the violation of the air outlet prevails over the violation of its entrance to the alveoli. As a result, air enters the lungs, but is not able to leave them in the same volume. In the later stages of the process, both the function of inhalation and inhalation suffers. The lungs are constantly inflated and contain high-pressure air with a high concentration of carbon dioxide. They seem to be switched off from the act of breathing.

Content:

• Causes of emphysema of the lungs
• Signs and symptoms of pulmonary emphysema
• Types of emphysema of the lungs
• Diagnostics of the lung emphysema
• Pulmonary emphysema treatment
• Surgical treatment of pulmonary emphysema
• Do I need hospitalization for emphysema treatment?
• Nutrition for emphysema (diet)
• Disease prognosis
• Consequences of emphysema

Causes of emphysema of the lungs

The causes of this pathology are divided into two groups.

1. Violation of the elasticity and strength of lung tissue:

   • Congenital structural features of the lung tissue. The pressure in the alveoli rises due to the collapse of the bronchioles due to congenital defects.
   • Hormonal imbalance. The smooth muscles of the bronchioles lose their ability to contract due to an imbalance between estrogens and androgens. The consequence of this is the stretching of the bronchioles and the formation of voids in the lung parenchyma.

   • Inhalation of polluted air mixed with tobacco smoke, coal dust, smog, toxins. The most dangerous impurities are oxides of sulfur and nitrogen, which are by-products of automotive fuel processing and emissions from thermal power plants. Microparticles of these compounds are deposited on the walls of the bronchioles. They affect the vessels of the lungs feeding the alveoli, damage the ciliated epithelium, and activate alveolar macrophages. Additionally, the level of neutrophils and proteolytic enzymes increases, leading to the destruction of the walls of the alveoli.
   • Congenital deficiency of alpha-1 antitrypsin. This pathology leads to the fact that proteolytic enzymes acquire unusual functions - instead of destroying bacteria, they destroy the walls of the alveoli. Normally, alpha-1 antitrypsin should neutralize these manifestations immediately after they occur.
   • Age-related changes. The blood circulation of an elderly person undergoes changes for the worse, and the sensitivity to air toxins increases. In older people, lung tissue regenerates more slowly after pneumonia.
   • Respiratory tract infections. When pneumonia or bronchitis occurs, immunity stimulates the activity of protective cells: macrophages and lymphocytes. A side effect of this process is the dissolution of the protein of the walls of the alveoli. Additionally, sputum clots do not allow air to pass from the alveoli to the exit, which leads to tissue stretching and overfilling of the alveolar sacs.

2. Increased pressure in the lungs:

   • Occupational hazards. The costs of the profession of musicians of wind instruments, glass blowers - increased air pressure in the lungs. Long-term exposure to these hazards leads to impaired blood circulation in the walls of the bronchi. Due to the weakness of the smooth muscles, part of the air remains in the bronchi, the next portion is added to it when inhaling. This leads to the appearance of cavities.
   • Chronic obstructive bronchitis. With this pathology, the patency of the bronchioles is impaired. When you exhale, air does not come out of your lungs completely. Because of this, both the alveoli and small bronchi are stretched, and cavities appear in the lung tissues over time.
   • Blockage of the bronchial lumen by a foreign body. Causes an acute form of emphysema, since air from this segment of the lung cannot escape.

The exact cause of the appearance and development of this pathology has not yet been established. According to scientists, several factors influence the appearance of lung emphysema.

Signs and symptoms of pulmonary emphysema

• Cyanosis - the tip of the nose, earlobes, and nails become bluish. With the development of the disease, the skin and mucous membranes become pale. The reason is that small capillaries are not filled with blood, oxygen starvation is recorded.
• Dyspnea of an expiratory nature (with difficulty exhaling). Insignificant and imperceptible at the beginning of the disease, it progresses in the future. It is characterized by difficult, staggered exhalation and gentle inhalation. Due to the accumulation of mucus, the exhalation is elongated and puffing. Differentiation from dyspnea in heart failure is not aggravated by lying down.
• Intense work of the muscles that provide breathing. To ensure the lungs work on inhalation, the muscles that lower the diaphragm and raise the ribs are intensely tense. On exhalation, the patient strains the abdominal muscles that raise the diaphragm.
• Swelling of the neck veins. It occurs due to an increase in intrathoracic pressure during coughing and exhalation. With emphysema, complicated by heart failure, the neck veins swell when you inhale.
• Blushing of complexion during a coughing fit. Thanks to this symptom, patients with emphysema have received the nickname "pink puffers." The amount of discharge when coughing is small.
• Weight loss. The symptom is associated with excessive activity of the muscles that provide breathing.
• An increase in the size of the liver, its prolapse. It occurs due to stagnation of blood in the vessels of the liver and the prolapse of the diaphragm.
• Appearance changes. Appear in patients with long-term chronic emphysema. Signs: short neck, protruding supraclavicular fossa, barrel-shaped chest, sagging belly, intercostal spaces retracted while inhaling.

Types of emphysema of the lungs

Emphysema is classified into several categories.

By the nature of the flow:

• Sharp. It can be caused by significant physical activity, an attack of bronchial asthma, the ingress of a foreign object into the bronchial network. There is a swelling of the lung and hyperextension of the alveoli. The condition of acute emphysema is reversible, but requires urgent treatment.
• Chronic. Changes in the lungs occur gradually, at an early stage a complete cure can be achieved. Leads to disability without treatment.

By origin:

• Primary emphysema. The origin is associated with innate characteristics of the body. It is an independent disease, diagnosed even in newborns and infants. Poorly treatable, progresses at an accelerated pace.
• Secondary emphysema. The origin is associated with the presence of chronic obstructive pulmonary disease. The onset of the disease can go unnoticed, the increase in symptoms leads to disability. If the disease is not treated, the size of the cavities that appear can be significant, occupying entire lobes of the lungs.

By prevalence:

• Diffuse form. Tissue damage and destruction of the alveoli occurs throughout the lung tissue. Severe forms of the disease can result in donor organ transplantation.
• Focal form. Changes in the parenchyma are diagnosed around the foci of tuberculosis, scars, the place of bronchial obstruction. Symptoms of emphysema are less severe.

By anatomical features, in relation to the acinus:

• Panacinar (vesicular, hypertrophic) form. It is diagnosed in patients with severe emphysema. There is no inflammation, there is respiratory failure. There is no healthy tissue between damaged and swollen acini.
• Centrilobular form. Destructive processes affect the central part of the acinus. Due to the expansion of the lumen of the bronchi and alveoli, an inflammatory process develops, and mucus is secreted in large quantities. Fibrous degeneration of the walls of the damaged acini occurs. The intact parenchyma of the lungs between the sites that have undergone destruction performs its functions unchanged.
• Periacinar (parasepital, distal, perilobular) form. It develops in tuberculosis, with this form, the extreme sections of the acinus near the pleura are affected. It may end with a complication - rupture of the affected area of the lung (pneumothorax).
• Okolubtsovaya form. It is characterized by minor symptoms, manifests itself near fibrous foci and scars in the lungs.
• Bullous (bubbly) form. Near the pleura or throughout the parenchyma, bullae (bubbles) with a diameter of 0.5-20 cm are formed. They appear at the site of damaged alveoli. They can rupture, become infected, and squeeze the surrounding tissues.
• Insternal (subcutaneous) form. Due to the rupture of the alveoli, air bubbles form under the skin. They move along the lymphatic ducts and the gaps between tissues under the scalp and neck. Spontaneous pneumothorax can occur due to rupture of vesicles left in the lungs.

Due to the occurrence:

• Senile emphysema. It occurs due to age-related changes in blood vessels, violations of the elasticity of the walls of the alveoli.
• Lobar emphysema. It is observed in newborns, appears due to obstruction of one of their bronchi.

Bullous emphysema of the lungs

Bullous emphysema is understood as a critical violation of the structure of the lung tissue, in which the interalveolar septa are destroyed. This creates one large cavity filled with air. Bullous emphysema can occur against the background of general emphysema of the lungs, as one of the extreme stages of its development, and it can also develop against the background of healthy surrounding lung tissue. Inflammatory and suppurative processes in the lungs, especially with a chronic course (chronic abscess, bronchiectasis, tuberculous foci) contribute to such a bullous transformation. The mechanism of its appearance at first has a vicarious character of emphysema, which over time transforms into a bull.

If bullous emphysema is represented by single bullae on the surface of the lungs, the person is usually unaware of its existence. It is not available for diagnosis even with an X-ray examination. The situation is quite different with multiple bullae over the entire surface of the lung tissue. Such patients have all the symptoms of pulmonary emphysema, including signs of respiratory failure of one degree or another.

The danger of bullous emphysema arises with severe thinning of the superficial membrane of the bulla. In this case, there is an extremely high risk of rupture. This is possible with sudden changes in pressure in the chest (cough, physical exertion). When the bulla ruptures, air from the lungs rushes into the pleural cavity. A dangerous condition called pneumothorax occurs. At the same time, the air accumulated in the pleural cavity creates high pressure, which compresses the affected lung. If the defect in the lung tissue is large enough, it is not able to close on its own, which leads to a continuous flow of air into the pleural cavity. When its level becomes critical, it begins to enter the mediastinum and subcutaneous tissue, which causes the development of subcutaneous and mediastinal emphysema. It is very dangerous,as it can result in decompensated respiratory failure and cardiac arrest.

Diagnostics of the lung emphysema

Medical examination

At the first symptoms or suspicion of emphysema, the patient is examined by a pulmonologist or therapist.

The survey takes place according to the following scheme:

1. The first stage is taking anamnesis. Approximate topics of questions to the patient:

   • How long does the cough last?
   • Does the patient smoke? If so, how long, how many cigarettes does he use per day?
   • Is there shortness of breath?
   • How the patient feels with increased physical activity;

2. Percussion is a special technique of tapping the chest with the fingers of the right hand through the palm of the left placed on the chest. Possible symptoms:

   • Limited lung mobility;
   • "Box" sound over areas of increased airiness;
   • Descent of the lower edge of the lungs;
   • Difficulty determining the boundaries of the heart.

3. Auscultation - listening to the chest with a phonendoscope. Possible manifestations of the disease:

   • Strengthening exhalation;
   • Muffled heart sounds due to absorption of sound by air-filled lung parenchyma;
   • Weakened breathing;
   • When bronchitis is attached - dry wheezing;
   • Tachycardia - an attempt to compensate for the heart to compensate for oxygen deprivation due to increased heart rate;
   • Strengthening of the second heart tone as a result of increased blood pressure in the pulmonary circulation, as a sign of damage to the right half of the heart;
   • Rapid breathing with a frequency of 25 or more breaths within a minute, as a sign of overstrain of the respiratory muscles and respiratory failure.

Instrumental methods for diagnosing pulmonary emphysema

1. X-ray is an examination of the lungs with their images on a special film using X-rays. The picture is performed in direct projection, when the study is carried out in the position of the patient facing the apparatus When analyzing the image, the doctor identifies the pathology of the lungs and the stage of the process spread. If it is necessary to clarify the diagnosis, magnetic resonance imaging and computed tomography, spirometry are prescribed.

   Indications for research:

   • Annual check-up,
   • Dyspnea,
   • Weak breathing
   • Wheezing, pleural friction noise when listening to the chest,
   • Prolonged cough
   • Suspected tuberculosis or pneumonia, bronchitis, emphysema;
   • Pneumothorax.

   Contraindications: lactation and pregnancy.

   Possible symptoms:

   • Enlargement of the lungs, their superposition, compression of the mediastinum;
   • The transparency of the affected areas;
   • Extended intercostal spaces;
   • Changes in the vascular system of the lungs;
   • Descent of the lower edge of the lungs and diaphragm;
   • Detection of bulls and air pockets.

2. Magnetic resonance imaging (MRI) of the lungs is a study that detects differences in the absorption of radio waves by cells of the human body. Magnetic resonance imaging provides information on the presence of fluid and foci of pathology, on the state of the bronchi. To create a complete picture, slices of 1 cm thick are made, a contrast agent is injected into certain areas of the body. The lack of research - accurate visualization is hampered by the presence of air in the small bronchi and alveoli. The research is carried out within half an hour. The absence of radiation makes MRI possible for pregnant women.

   Indications for conducting:

   • Symptoms indicate the presence of cysts, tumors, but the X-ray did not show them;
   • Suspected sarcoidosis, tuberculous lung disease;
   • Swollen lymph nodes in the projection of the lungs;
   • There are abnormalities in the development of the respiratory system.

   Contraindications:

   • Mental illnesses that prevent the maintenance of a long immobile position;
   • Fear of enclosed spaces;
   • Severe obesity;
   • The presence of implants, a pacemaker, not removed fragments.

   Symptoms of emphysema on MRI:

   • Bullae and cavities of various sizes;
   • Enlarged lung
   • Compression of healthy tissue;
   • An increase in the amount of fluid in the pleura;
   • Damage to the alveoli and their capillaries;
   • Impaired blood supply;
   • The omission of the diaphragm.

   

3. Computed tomography (CT) of the lungs. The method of computed tomography is based on the reflection of X-rays by the tissues of the human body. The output is a layered computer image of the structure of the lungs. For more information, a contrast agent is injected. The procedure takes place within 20 minutes. During this period, the lungs are scanned with an X-ray emitter. The disadvantage of this method is the significant exposure of the patient.

   Indications:

   • Clarification of X-ray examination data;
   • Suspected emphysema;
   • Preparation for bronchoscopy or lung biopsy;
   • Justification of the need for surgery;
   • Diffuse change in lung tissue.

   Contraindications:

   • Individual intolerance to contrast medium;
   • Diabetes mellitus in severe form;
   • Pregnancy;
   • Severe obesity;
   • Extreme weakness;
   • Renal failure

   Symptoms of emphysema:

   • Revealing the area of extended areas;
   • Fixing the size and location of the bulls;
   • Expansion of blood vessels at the root of the lung;
   • The emergence of airy areas.

   

4. Lung scintigraphy. A method for studying the lungs by introducing radioactive isotopes (technetium-99M) into them. The gamma camera rotates around the patient and takes pictures of the organ.

   Indications:

   • Diagnostics of blood vessels at an early stage of emphysema development;
   • Preparation for surgery - assessment of the state of the operating field;
   • Suspected cancer of the lung;
   • Monitoring the effectiveness of conservative therapy.

   Pregnancy is an absolute contraindication to testing.

   Symptoms of emphysema:

   • Blood flow disorders;
   • The appearance of areas of compression of the lung tissue.

5. Spirometry. A research method for studying the volume of external respiration, carried out using a spirometer. The device registers the amount of air in the patient's inhalation and exhalation.

   Indications:

   • Prolonged cough;
   • Respiratory pathology;
   • Long-term experience of a smoker;
   • Exposure to occupational hazards;
   • Respiratory tract diseases (asthma, obstructive bronchitis, pneumosclerosis).

   Contraindications:

   • Tuberculosis;
   • Hypertension;
   • Condition after stroke and heart attack, operations on the chest and peritoneum;
   • Pneumothorax;
   • Bloody sputum.

   Disease symptoms:

   • Changes in vital and residual lung capacity indicators;
   • Decreased ventilation and speed performance;
   • Increased airway resistance;
   • Decreased distensibility of the lung parenchyma.
6. Peak flow - measurement of the maximum expiratory flow rate to determine bronchial obstruction. Method for determining bronchial obstruction. The peak flow meter measures the expiratory flow 3 times before taking the medication. The disadvantage of this method is the impossibility of establishing a diagnosis of emphysema. The method determines diseases accompanied by pulmonary obstruction. There are no contraindications.

7. Determination of blood gas composition. A method for studying the ratio of oxygen and carbon dioxide in the blood, for assessing the enrichment of arterial blood with oxygen and purifying it from carbon dioxide. Blood taken from the cubital vein is placed in a heparin syringe to prevent premature clotting.

   Indications:

   • Signs of a lack of oxygen (cyanosis);
   • Respiratory disorders in lung diseases.

   Symptoms:

   • Blood oxygen less than 15%;
   • Oxygen tension less than 60-80 mm Hg;
   • Carbon dioxide voltage is more than 50 mm Hg.

8. General blood analysis. Method for determining the characteristics of blood cells. The method is informative for any disease, has no contraindications.

   Deviations from the norm with emphysema:

   • increased number of red blood cells over 5 10 ¹² / l
   • increased hemoglobin level over 175 g / l
   • increased hematocrit over 47%
   • reduced erythrocyte sedimentation rate 0 mm / hour
   • increased blood viscosity: in men over 5 cps in women over 5.5 cps

Pulmonary emphysema treatment

Treatment directions:

• Fight against further development of the disease;
• Prevention of severe complications (respiratory and heart failure);
• Improving the quality of life of patients.

Mandatory treatment measures:

• Conservative therapy for easier breathing, better lung function;
• To give up smoking;
• Performing a complex of medical gymnastics for lung ventilation;
• Treatment of the underlying cause of the disease.

Emphysema treatment (medications)

Drug names	The mechanism of therapeutic action	Mode of application
A1-antitrypsin inhibitors	Prolastin	The introduction of this protein reduces the level of enzymes that destroy the connective fibers of the lung tissue.	Intravenous injection at the rate of 60 mg / kg body weight. Once a week.
Mucolytic drugs	Acetylcysteine (ACC)	Improves the discharge of mucus from the bronchi, has antioxidant properties - reduces the production of free radicals. Protects the lungs from bacterial infection.	It is taken orally 200-300 mg 2 times a day.
	Lazolvan	Thinns mucus. Improves its excretion from the bronchi. Reduces cough.	Used internally or by inhalation. Inside during meals, 30 mg 2-3 times a day. In the form of inhalations with a nebulizer, 15-22.5 mg, 1-2 times a day.
Antioxidants	Vitamin E	Improves metabolism and nutrition in lung tissues. Slows down the process of destruction of the walls of the alveoli. Regulates the synthesis of proteins and elastic fibers.	Take orally 1 capsule per day. Accepted in courses of 2-4 weeks.
Bronchodilator (bronchodilator) agents Phosphodiesterase inhibitors	Teopek	Relaxes the smooth muscles of the bronchi, helps to expand their lumen. Reduces swelling of the bronchial mucosa.	The first two days take half a tablet 1-2 times a day. In the future, the dose is increased - 1 tablet (0.3 g) 2 times a day after 12 hours. It is taken after meals. The course is 2-3 months.
Anticholinergics	Atrovent	Blocks acetylcholine receptors in the muscles of the bronchi and prevents their spasm. Improves indicators of external respiration.	In the form of inhalations 1-2 ml 3 times a day. For inhalation in a nebulizer, the drug is mixed with saline.
Theophylline	Sustained-release theophylline	It has a bronchodilator effect, a decrease in systemic pulmonary hypertension. Strengthens diuresis. Reduces fatigue of the respiratory muscles.	The initial dose is 400 mg / day. Every 3 days it can be increased by 100 mg until the desired therapeutic effect appears. The maximum dose is 900 mg / day.
Glucocorticosteroids	Prednisolone	It has a strong anti-inflammatory effect on the lungs. Promotes the expansion of the bronchi.	Applied with the ineffectiveness of bronchodilator therapy. At a dose of 15–20 mg per day. Course 3-4 days.

Treatments for emphysema

• Electrical stimulation through the skin of the intercostal muscles and diaphragm. It is carried out with impulse currents with a frequency of 5-150 Hz, individually selected for each patient. The procedure is aimed at facilitating exhalation, improving lymph circulation and blood circulation, and providing muscles with energy. The prevention of muscle fatigue and further respiratory failure is effectively carried out. During electrical stimulation, the smallest muscle contractions occur, which are not accompanied by pain. A course of 10-15 sessions is conducted.
• Oxygen inhalation. Long-term procedure (up to 18 hours in a row) breathing through an oxygen mask. In severe cases, oxygen-helium mixtures are used.
• Breathing exercises. A set of specially selected exercises to strengthen the respiratory muscles is carried out for 15 minutes 4 r / day.

The complex includes a slow exhalation into water through a cocktail straw, an exercise for diaphragmatic breathing with abdominal retraction and inflation, as well as squeezing while lying down with abdominal tension.

Surgical treatment of pulmonary emphysema

Surgical treatment is prescribed in rare cases, when drugs are ineffective, a large area of lung damage.

Indications for surgery:

• Multiple bullae (more than a third of the chest area);
• Severe shortness of breath;
• Complications of the disease: pneumothorax, oncological process, bloody sputum, infection.
• Frequent hospitalizations;
• The transition of the disease to a severe form.

Contraindications to surgery may be severe exhaustion, old age, chest deformity, asthma, pneumonia, and severe bronchitis.

Types of operations for lung emphysema

• Lung transplantation (lobe, together with the heart), replacement with a donor organ. It is carried out with extensive organ damage, multiple bullae. Complications - rejection of the donor organ.
• Reduction of up to a quarter of the lung volume with the removal of damaged areas by opening the chest. After removal of the affected lobe of the lung, sealing sutures are applied.
• Minimally invasive method (thoracoscopy) to remove the affected area of the lung. It is carried out under the control of a video camera by making three incisions: for the camera and the surgeon's instruments.
• Bronchoscopy. It is carried out through the oral cavity, provided that the affected area is located near the large bronchi.

As a result of the surgical intervention, ventilation of the lung is restored; it is not compressed by pathologically enlarged areas. After 3 months, the patient feels a significant improvement in his condition. Shortness of breath may return 7 years after surgery.

Do I need hospitalization for emphysema treatment?

Subject to the doctor's recommendations, optimal diet and medication regimen, outpatient treatment of the disease is possible.

Reasons for inpatient treatment:

• clarification of the diagnosis;
• intensification of symptoms, the appearance of new signs (cyanosis of the skin and mucous membranes, weakness, shortness of breath without exertion, sputum production with blood);
• simultaneously occurring serious diseases;
• the appearance of arrhythmia;
• ineffectiveness of outpatient treatment (worsening of peak flowmetry indicators).

Nutrition for emphysema (diet)

Diet No. 11 and No. 15 is aimed at strengthening the immune system, detoxifying the body and replenishing the patient's energy supply.

Diet principles:

• The calorie content of the daily diet is not less than 3500 kcal. Diet - 4-6 times a day, little by little.
• Fat intake - at least 80-90 g. It can be vegetable and butter, dairy products with high fat content. The ratio of the proportion of animal fats to vegetable fats is 2: 1.
• Proteins are consumed in amounts up to 120 g per day. There must be at least half of animal products (eggs, meat of all sorts, sausages, sea and river fish, seafood, liver). Fried meat is excluded.
• The amount of carbohydrates in the diet is from 350 to 400 g. These are cereals, bread, jam, honey, pasta.
• Providing vitamins through the use of fresh fruits and vegetables, the introduction of bran into food.
• The use of any drinks is allowed: juices, koumiss, rosehip compote.
• Limiting salt to 6 g to prevent edema and cardiac complications.

The diet of patients with emphysema should not contain alcohol, cooking fats, confectionery products with a high fat content.

Disease prognosis

Emphysema of the lungs refers to the complications of bronchopulmonary diseases. This means that the changes in the lung tissue that have arisen in this case are irreversible. All that remains is to slow the progression of the disease and reduce the signs of respiratory failure by improving the patency of the bronchi.

Therefore, the prognosis for pulmonary emphysema depends on:

1. Timeliness and adequacy of treatment of the underlying disease;
2. An early and correct therapeutic approach to the treatment of emphysema;
3. Compliance by the patient with all medical and lifestyle recommendations;
4. Duration of the disease.

In any case, it will not be possible to finally get rid of emphysema of the lungs under any circumstances. But you can influence the progression of the disease. If the underlying disease of the bronchopulmonary system, which caused pulmonary emphysema, is characterized by a relatively stable course, then the prognosis for maintaining emphysema at its minimum level is quite favorable. If you follow all the recommendations of experts, then the signs of respiratory failure will be insignificant and the person will be able to live in his usual rhythm.

The prognosis in the case of decompensated bronchial diseases with severe emphysema is in any case unfavorable. Such people are forced to take expensive drugs for life, which can only support the basic vital parameters of breathing. Noticeable improvements in the quality of life are extremely rare. Life expectancy depends on the degree of compensation of the pathological process, age and restorative resources of the body.

Consequences of emphysema

Complications of this disease can be fatal. Any symptoms that indicate complications are a signal for immediate medical attention.

• Pneumothorax. In this complication, the pleura that protects the lung is torn. Air comes out into the pleural cavity, the lung collapses and can no longer straighten out. Fluid appears in the pleural cavity. The main symptoms of pneumothorax are severe chest pain, aggravated by inhalation, tachycardia, and a feeling of panic. If immediate action is not taken within 4-5 days, surgery will be required to expand the lung.
• Development of bacterial infections. Due to the reduced local immunity, the lungs' resistance to infection decreases. Severe lung inflammation and bronchitis become chronic. Symptoms: hyperthermia, cough with purulent discharge, weakness.
• Right ventricular heart failure. The destruction of small capillaries leads to pulmonary hypertension - an increase in blood pressure. The increased load on the right parts of the heart leads to their rapid aging and deterioration. Death due to heart failure is one of the leading causes of death in emphysema. Symptoms such as the appearance of edema, swelling of veins in the neck, pain in the heart and liver are a reason for an immediate emergency call.

Emphysema of the lungs has a favorable prognosis if the following conditions are met:

• Prevention of lung infections;
• Quitting bad habits (smoking);
• Providing a balanced diet;
• Living in a clean air environment;
• Sensitivity to medicines from the group of bronchodilator drugs.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".