The main functions of respiration is the process of exchange. By breathing oxygen contained in the air is red blood cells (RBCs) and exhale back Pdischarged carbon dioxide (emissions). contact between air and body occurs in the lung sacs (alveoli). alveolar lung internal surface of about seventy square meters, while as the skin is just one and a half to two square meters. emphysema constantly expanding airspace distal to terminal bronchioles accompanied by destruction (destruction) of alveolar barrier. total lung capacity in emphysema increases with increasing due to the so-called dead space, which does not participate in gas exchange.
Emphysema begins with the destruction of alveolar walls, where exchange of oxygen and carbon dioxide in the blood capillaries. Reducing transport oxygen Clinically the disease manifests difficulty breathing (dyspnea) and cyanosis PTypes emphysema .. When it affects the entire block airways (slices ) In these cases, emphysema is often the result of genetic abnormalities inherited deficiency of alpha-1 antitrypsin This substance. protease inhibitor. Its function is to inhibit the activity of enzymes that destroy the elastic fibers in alveolar walls. alpha-1 antitrypsin is present in serum, biological fluids and macrophages and is a major inhibitor of neutrophil proteases released (while blood cells) in inflammation. With frequent lung infections (acute bronchitis, pneumonia, chronic bronchitis) due to the increased presence of neutrophilic leukocytes increases the number of proteases and thus leads to increased destruction of elastic fibers in the lung parenchyma. level of alpha -1 antitrypsin can be detected in the blood. On the surface of the lungs and the cut surface shows a wreath of preserved alveoliP advanced emphysema around the central regions. respiratory bronchioles and involved mainly in the upper lobes. It emphysema in clinical and experimental smokers. Tobacco smoke causes leukocyte and macrophage chemotaxis (attraction of blood cells) issues incoming oxidants and elastase cigarette smoke blocks the alpha-1 antitrypsin. consequences of the destruction of elastic fibers and the development of emphysema. With this type of emphysema suffer only smokers. On them, but ..... only 15-20% develop pulmonary emphysema in 95% of patients older than 45 years, sharing the floor almost equally 54 8% of men and 45 women, 2% Smoking leads to:
- Defeat the balance between elastase and alpha-1antitrypsin -. migration of inflammatory cells from blood capillaries into the alveoli -. division enzymes (elastase, collagenase) from inflammatory cells -. oxidants in cigarette smoke inhibit the action of elastase inhibitor (alpha-1 antitrypsin) These two. disease and lead to emphysema in the so-called valve mechanism in inhalation (inspirium) in alveoli receive a large volume of air that can not be released after. Senile emphysema associated with atrophy of elastic fibers after 70 years. There is no destruction of alveolar walls. symptoms of pulmonary emphysema There are two versions of the final clinical version emphysema, and between the transitional forms that coverP somewhat range of symptoms. pink and flaky type of people with normal weight or thin, emaciated patients with dry irritating cough without cyanosis (blue in the face). They suffer from marked shortness of breath (dyspnea). blue and swollen type of people who are overweight, with marked cyanosis (blue in the face of the skin and visible mucous membranes). They cough accompanied by sputum and moisture. You do not have shortness of breath. for emphysema patient is characteristic barrel chest with a horizontal course of ribs, protruding over the field energy clavicle wells percussion soaked breath and decreased heart tones (due to overlapping heart swollen lungs). aperture low status and putting pressure on the liver that can lead to false diagnosis enlargement of the liver. X-ray shows increased transparency lung fields, with the expansion of intercostal spaces. pulmonary function (PFT), as well as analysis of blood gas composition accurately determine the extent of the destruction of lung pneumothorax, pulmonary hypertension from chronic pulmonary heart (pulmonary heart), respiratory failure treatment emphysema - .. Quitting smoking, dust-free working environment -. timely treatment and prevention of pulmonary infections. - In the highly recommended sputum mucolytic drugs thins bronchial secretions, and in severe cases, corticosteroids and bronchodilators -. oxygen treatment of Attention InPpatients R emphysema ParePabsolutelyPcontraindicatedPdrugsPthat suppressPrespirationP (morphine, Pdiazepam, barbiturates, sleeping pills) Treatment withPbronchodilatorsPand corticosteroidsPshould.! performedPonly be doctors-Pspecialists! Treatment withPantibiotics isPappropriate toPtakePplace after microbiological sputum examinationPof and preparationPof antibiohrammoy! Oxygen supplyPforPbreathingPrequiresPdosing andPconstant medical supervision, Pbecause too buy lasix 100 mg muchPcanPlead toPdepressionPof respiratory centerPand risk ofPrespiratory arrest. breathing techniques, which should absorb the emphysema patient to breathe with sharp lips (called brake on the lips). Thus, to avoid collapse of airways during exhalation so-called expiratory collapse. Primus breathing (fast, hard), should be avoided, this is means that patients must be protected from severe physical and emotional effort outbreak, leading to an increase in respiratory movements.
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