Emphysema (cont.)

These programs involve primarily two components, education and exercise.

Patient education includes:

• proper breathing techniques,
• clearance of secretions,
• understanding their medications and devices,
• efficient body mechanics, and
• networking with other lung patients.

All of the above are essential components of emphysema treatment. Graded physical exercise under supervision allows for better patient mobility. A multidisciplinary program helps improve the patient's quality of life and decreases the number of hospitalizations for exacerbations of their underlying disease.

Depending upon what type of damage has occurred to the lung, there is potential to have surgery to decrease the lung volume and help minimize the symptoms of emphysema. Because patients with this disease tend to be older, more ill, and have associated underlying medical problems, this treatment is very patient-specific and is not routinely offered.

Studies have demonstrated that patients with emphysema primarily affecting the upper lobes of both lungs may benefit most from lung volume reduction surgery, often by removing larger bullae.

Emphysema is a disease that affects quality of life and not necessarily the quantity of life. The goal for treatment of emphysema is to prevent further lung damage, and to maximize the function of the remaining healthy lung tissue.

Symptoms of emphysema occur because the body is not being supplied with adequate oxygen, and because it takes significant effort to take deeper breaths. These both contribute to the very miserable sensation of constantly feeling short of breath.

There are no studies that have been able to predict mortality from emphysema, but the U.S. Centers for Disease Control and Prevention report that 127,000 people died from COPD in 2009. In comparison, five times as many people died of heart attack, and four times as many due to cancer.

The BODE score can help measure quality of life and prognosis for future function.

• B = Body Mass Index (BMI).
• O = Obstruction. Lung function based on pulmonary function tests.
• D = Dyspnea (breathlessness)
• E = Exercise capacity. How far the emphysema patient can walk in 6 minutes

Neither the GOLD or BODE scores can predict longevity or mortality but are guidelines to assess the severity of emphysema and how it may affect future lifestyle.

REFERENCES:

CDC.gov. Leading Causes of Death.

Tintinalli J, etal. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th edition. McGraw-Hill Professional 2010

Source: MedicineNet.com
http://www.medicinenet.com/emphysema/article.htm