Empysema

Presentation TitleEMPHYSEMA BY SUMAN RAY (M.PHARM)

What is Emphysema?

• Emphysema is a long term disease of the lungs that damages the function of it.

• This disease can cause shortness of breath.• While having this disease, necessary tissue in

the lung is destroyed, as well as the airways.• Little structures called alveoli exchange the

oxygen in the air for CO2 in the blood stream. Emphysema causes small holes to be created in the alveoli, therefore not enough oxygen is getting to the bloodstream.

• Little structures called alveoli exchange the oxygen in the air for CO2 in the blood stream. Emphysema causes small holes to be created in the alveoli, therefore not enough oxygen is getting to the bloodstream.

ANATOMICAL AND PHYSIOLOGICAL ABNORMALITIES

SMOKINGAIR POLLUTION

LUNG INFLAMMATIONLEUCOCYTES

PROTEOLYTIC ENZYMES

ALPHA 1-ANTITRYPSIN

OTHER INFLAMMATORY

MEDIATORS

EMPHYSEMA

GAS EXCHANGE

DESTRUCTION OFLUNG TISSUES

AIRWAYS ELASTICS

LUNG COMPLICATION

classification

• Panacinar (or panlobular) emphysema: The entire respiratory lobule, from respiratory bronchiole to alveoli, has expanded. Occurs more commonly in the lower lobes (especially basal segments) and in the anterior margins of the lungs.

• Centriacinar (or centrilobular) emphysema: The respiratory bronchiole (proximal and central part of the acinus) has expanded. The distal acinus or alveoli are unchanged. Occurs more commonly in the upper lobes.

Special types Of emphysema

• Congenital lobar emphysema• CLE results in overexpansion of a 

pulmonary lobe, and resultant compression of the remaining lobes of the ipsilateral lung (and possibly also the contralateral lung). There is bronchial narrowing because of weakened or absent bronchial cartilage.There may be congenital extrinsic compression, commonly by an abnormally large pulmonary artery.

Paraseptal emphysema

• Paraseptal emphysema is a type of emphysema which involves the alveolar ducts and sacs at the lung periphery. The emphysematous areas are subpleural in location and often surrounded by interlobular septa (hence the name). It may be an incidental finding in young adults, and may be associated with spontaneous pneumothorax. It may also be seen in older people with centrilobular emphysema. 

How Can You GeT Emphysema?

• Emphysema is mostly caused by smoking; it affects the lungs in two ways.

How Can You Get Emphysema?

• Another way of getting emphysema is by air pollution. How this affects your lungs is similar to the way smoking does.

• Also, if you have asthma, you are at a greater risk because your lungs are already not functioning properly.

• If you are a close relative of someone who has it, you have a greater chance of having it.

• Men have a greater chance of getting it than women.

• Lastly, the older you are, the greater risk you have because lung function declines as you grow older.

Emphysema Symptoms

• One of the symptoms is shortness of breath. You cough or wheeze because of the mucus buildup.

• A decreasing tolerance for exercise is another sign of having emphysema.

• Next, the person with emphysema may become a “pursed-lip breather.” He may struggle to exhale completely because the airways collapse and cannot hold up. A “pursed-lip breather” will purse his lips to allow air to come in and out of his lungs.

Emphysema’s Treatment

Bronchodialation : the antimuscarinic bronchodialators,ipratopium and tiotropium seems to be as effective as the β2-agonists & a combination of a β2-agonist & an antimuscaranic gives an superior results.

Corticosteroid therapy: RCTs have indicated clearly that the combination of a corticosteroids and LABA(Fluticasone plus salmeterol & budesonide plus formoterol) improve the lung function and quality of life compared to the indivisual agents.

OXYGEN> LTOT(02 used for at least 15hr daily) improves the mobility , relieves hypoxaemia & reduce the mortilty of severe hypoxaemia.

More Facts

In 2000, 2.74 million people all around the world died from different types of Chronic Obstructive Pulmonary Disease (COPD), which emphysema can be categorized as.

The World Health Organization (WHO) says that COPD is tied 4th/5th place with HIV/AIDS as the single cause of death.

Emphysema is the 4th leading cause of death in the United States, and is predicted to be the 3rd by the year 2020.

5%

41%

54%

Percentage of Distribution Of Emphysema (Age)

18-44

45-64

65+

Bibliography

Anderson, Gerard F.; Gross, Cary P.; Powe, Neil R. “COPD Statistical Information.” http://www.copd-international.com/library/statistics.htm, March 16, 2004

-Kittredge, Mary; Koop, C. Everett; Thurman, Sandra. The Respiratory System. New York: Chelsea House Publishers, 1989. pg. 40-42