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Emphysema & LVRS

mphysema is a type of chronic lung disease.It gradually damages the air sacs of lung & patient becomes breathless.It is a type of chronic obstructive pulmonary disease. Smoking is the leading cause of this disease,the other major known causes are alpha -1 antitrypsin deficiency.Second hand smoke & air pollution also contribute to emphysema of lung.Medical management is the mainstay of treatment. In some patients Lung Volume Reduction Surgery (LVRS) is performed.In LVRS about 20-35% of emphysematous lung are removed this helps in the function of remaining lungs& intercostals muscles.Ther are specific criteria which must be fulfilled before considering a patient for LVRS.

1) What is Emphysema?

Ans:It is a chronic disease of lung arising out of destruction of air sacs of lung.smoking & chronic bronchitis commonly leads to this disease.

2) What are the symptoms & signs of emphysema which are worrisome?

Ans:Increase in Shortness of breath in spite of medications,increased cough with expectoration,palpitation, drowsiness,bluish discolouration of lips,tongues nailbeds if present needs urgent medical attention.

3) What are the usual management for emphysema?

Ans: Medical management with bronchodilators(Inhaler or nebulisation),steroids,antibiotics,chest physiotherapy & pulmonary rehabilitation are the usual management.

4) Is there any need for ventilatory support?

Ans:Sometimes if patient do not respond to medical management then he or she may need ventilator support.Ventilatory support may be Invasive (With Endotracheal tube) or Non Invasive(without tube by mask-In hospital or domiciliary)

5) what is the scope for surgery?

Ans:In a specific subset of patients Lung Volume reduction surgery may be done where a significant portion of lungs are removed.The surgery has its complications. In some critical patients Lung transplantation is indicated.