Chronic Emphysema

Excerpt

Pulmonary emphysema is defined as a pathological, permanent dilatation of distal airways (respiratory bronchioles, alveolar ducts, and alveolar sacs) due to the destruction of the walls of the airways without fibrotic changes. Emphysema destroys the essential ventilatory units and interrupts the gas exchange. Functionally, emphysema causes obstructive ventilatory defect evidenced in the spirometry and is included in the collective diseases of chronic obstructive pulmonary disease, commonly termed as COPD. Advanced emphysema is a common and serious cause of chronic respiratory failure and acute decompensation that could be life-threatening. Due to its high morbidity and mortality, recognizing and treating this condition in its early stages is vital. Emphysema is differentiated from interstitial pneumonia by the absence of fibrosis of the pulmonary interstitium. Notwithstanding, combined pulmonary fibrosis and emphysema (CPFE) has been documented as a separate clinical entity, in many patients with proven emphysema. Repeated exacerbations of emphysema and subsequent decompensation cause a rapid decline in lung function greater than expected from age.