Chronic Obstructive Pulmonary Disease (COPD) is not one single disease but an umbrella term used to describe chronic lung diseases that cause limitations in lung airflow. The more familiar terms 'chronic bronchitis' and 'emphysema' are no longer used, but are now included within the COPD diagnosis. The most common symptoms of COPD are breathlessness, or a 'need for air', excessive sputum production, and a chronic cough. However, COPD is not just simply a "smoker's cough", but a under-diagnosed, life threatening lung disease that may progressively lead to death.
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Q. What conditions can be treated with lung volume reduction surgery?
A. LVRS is an option for some people with severe emphysema, a chronic lung condition in which the alveoli--or air sacs--of the lungs are damaged and trap air. People with emphysema experience breathlessness, coughing, fatigue, and other problems because their lungs do not function properly.
Lab values were drawn during the last physician visit; would you expect arterial gases to be normal or abnormal? Identify the pathological process involved in your response. CH and other patients with emphysema are at risk for what complications because of the pathologic process of their disease?
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Lung Volume Reduction Surgery for Emphysema is an essential reference for those with an interest in emphysema and its surgical palliation. The editors and authors have made a major contribution to our understanding, study and treatment of this chronic and disabling condition.
Emphysema Essay | Medicine and Health Articles
The book is well-presented. The Table of Contents is detailed, and the Indices are organized by both Author and Subject. These features further enhance its value as a reference tool. Despite the multiplicity of authors, redundancy is minimal. Regrettably, although it is mentioned in the Preface, the checkered history of surgical interventions for emphysema is largely ignored. Such a review of our surgical heritage could have provided a fascinating perspective from which to assess and contrast the current rigorous analysis that this book represents.
The title of this volume is too modest; the book is more than a treatise on LVRS alone. The first few chapters include excellent overviews on the epidemiology, pathology, physiology and medical therapy of emphysema. The ensuing essays on LVRS cover a wide range of key topics, including both scientific and practical considerations. Especially helpful to those planning such procedures or developing such programs are the chapters on evaluation, anesthesia and outcomes. The last essay, aptly-titled “Not the Final Chapter: The National Emphysema Treatment Trial,” provides a fascinating insight into the historical, political and scientific contexts of this landmark study. The NETT is well-summarized in both the text and tables. Evaluation and management algorithms in both this chapter and Chapter 7 are particularly useful.
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Q. Who is a candidate for lung volume reduction surgery?
A. Not everyone with severe emphysema is a good candidate for LVRS. Being a good candidate for LVRS is an important factor for surgical success. A large, nationwide study completed in 2005 found that people with severe emphysema in the upper lobes of the lungs with decreased exercise capacity benefit the most from LVRS. The study also showed that patients who do not meet the criteria would receive little or no benefit from LVRS.