emphysema

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Related to surgical emphysema: flail chest, Tension pneumothorax

emphysema

(ĕmfĭsē`mə), pathological or physiological enlargement or overdistention of the air sacs of the lungs. A major cause of pulmonary insufficiency in chronic cigarette smokers, emphysema is a progressive disease that commonly occurs in conjunction with chronic bronchitis. It is found predominantly in people over age 45, but a genetically based early-onset form also exists. Symptoms are difficulty in breathing, cough with thick sticky sputum, and a bluish tinge of the skin. Progressive disease can result in disability, and in severe cases heart or respiratory failure and death.

Causes

Cigarette smoking is the cause of most cases of emphysema. Tobacco smoke damages the lungs' alveoli, the tiny air sacs through which inhaled oxygen is transferred to the bloodstream and carbon dioxide is passed back to the lungs to be exhaled. The lungs become less elastic and breathing becomes increasingly difficult. The genetic form of emphysema occurs earlier in life (worsened by, but not dependent upon cigarette smoking). It is caused by a rare genetic deficiency of the protein alpha1-antitrypsin. In the absence of antitrypsin, which normally functions to protect the lungs from damage, the walls of the alveoli are attacked by chemicals released in alveoli in response to tobacco smoke and air pollutants.

Treatment

Emphysematous lung damage is irreversible. Its progression can be slowed by giving up smoking. Treatment is aimed at increasing the functional capacity of the lungs and may include bronchodilators, administration of supplemental oxygen, or lung transplantation. Surgical removal of affected lung tissue (lung volume reduction surgery), aimed at allowing healthy areas of the lung room to function, is being studied for its effectiveness and safety. The genetic form is treated with supplemental antitrypsin administered by infusion or by a gene therapy technique that uses T cells (special immune cells that identify diseased or deformed cells) to deliver it to the desired cell sites.

emphysema

[‚em·fə′sē·mə]
(medicine)
A pulmonary disorder characterized by overdistention and destruction of the air spaces in the lungs.

emphysema

Pathol
1. a condition in which the air sacs of the lungs are grossly enlarged, causing breathlessness and wheezing
2. the abnormal presence of air in a tissue or part
References in periodicals archive ?
Tracheal necrosis and surgical emphysema: A rare complication of thyroidectomy.
1990 Surgical emphysema during restorative dentistry.
Complications in the form of surgical emphysema in 2 patients (25%), wound infection in 2 patients (25%), failure of lung to expand which was treated by negative suction with complete expansion of the lung in one case (12.5%) and tense ascites in another single case (12.5%) but there was no pleuritic pain or hypotension seen in any of our patients treated with bovoiodine.
* decompression of interstitial blebs resulting in pneumomediastinum, pneumothorax, pneumopericardium, pneumoperitoneum and or surgical emphysema.
In our study, surgical emphysema was noted in 0.2% patients which is less as compared to one of the published studies21
Intermediate complications were observed in 10 cases, 6 were due to surgical emphysema, 2 were tube blockage and remaining 2 cases were tube displacement & stomal infection.
Short term complications including haemorrhage, surgical emphysema, cardiac arrest and stomal infection were noted in both groups.
The necessity for high inflation pressures led to the development of gross surgical emphysema. Use of the interventional Lung Assist enabled a rapid correction of hypercapnoea and addosis, allowing a reduction in airway pressures, reducing further barotrauma.
Early complications include apneic attacks, surgical emphysema, pneumothorax or pneumomediastinum, accidental decannulation, creation of a false passage, obstruction of the tube, hemorrhage, and chest infections.
SPO2 remained at 92 to 93 % with a FiO2 of 100%.Within seconds she developed surgical emphysema of chest wall and also abdominal wall.
The hypoplastic lung is excessively fragile and hence susceptible to barotrauma, resulting in alveolar rupture, with progression to pulmonary interstitial emphysema, pneumomediastinum and pneumothorax and even, on rare occasions, surgical emphysema and air embolism.
Surgical emphysema was present over the left chest with marked tenderness along the lower ribs suggesting fractures.