Emphysema, Causes, Symptoms, and Treatment

Emphysema is a chronic, progressive, and debilitating disease, whose chief cause is smoking. This disease is characterized by the destruction of the air sacs (alveoli) in the lungs, limiting and preventing the escape of air flow from the lungs on exhalation.

As emphysema progresses, the air sacs, which are normally round, eventually become nothing more than holes that prevent oxygen from getting into the blood stream, thus preventing oxygen from reaching the body tissues. Emphysema is also a condition of chronic obstructive pulmonary disease, or COPD, resulting in severe respiratory difficulty that is non reversible.

Symptoms:

• Shortness of breath


• Productive or non productive cough


• Wheezing


• Cyanosis (blue tint to skin)

Diagnosis:

History and physical examination to assess for:

• Increased work to breathe, such as nasal flaring,


• Over-inflation of the lung


• Airflow in and out of the lung


• Heart rate, rhythm, and any signs of heart strain


• Chest x-ray and, possibly, a CT scan

Lung function tests determine the type and amount of lung damage. Tests include:

• Spirometry to measure breathing capacity


• Lung Volume to measure the amount of air in the lungs


• Diffusing Capacity to measure the lung's ability to transfer the gases


• Body Plethysmography evaluates degree of obstruction


• Arterial blood gases (ABG) analyzes amounts of carbon dioxide and oxygen


• Testing for alpha-1 antitrypsin deficiency (AAT deficiency)

Treatment:

A cure for emphysema does not exist, however, treatment involves the slowing the progression of the disease and managing symptoms. Treatment includes:

Medication:

Bronchodilators, corticosteroids, and supplemental oxygen. It should be noted that bronchodilators are mainly used for patients with chronic bronchitis, with or without the presence of emphysema. Bronchodilators are not helpful when the disease is emphysema by itself.

Breathing Retraining: Learning the pursed lips breathing technique, which is very effective for regaining control when short of breath.

Surgery:

Lung Reduction: Is a procedure that removes part of the diseased lung to allow the remaining part of the lung more room to expand. This procedure can reduce or eliminate the need for supplemental oxygen, as well as reduce the volume of lung over inflation.

Lung transplantation: A complex procedure that totally removes the diseased lung and replaces it with a healthy one from a newly deceased donor. This option requires life-long anti-rejection drugs to prevent the patient from rejecting the new lung.

Exercise: Will not increase lung capacity, but will keep the body from getting weak from inactivity.

Prevention:

The main cause of emphysema is smoking. To avoid getting this disease, stop smoking. Your health care provider can help you with ways to stop smoking. If you already have emphysema and still smoke, quitting smoking will help slow disease progression. Additionally, avoid smoke from fireplaces or wood-burning stoves. When the air pollution index is high, stay indoors and limit activity.

by Barb Hicks, RN