Treatment and prevention of emphysema

The treatment of emphysema first of all should be directed at eliminating the exacerbation of chronic bronchitis and pneumonia. Small pockets of bronchopneumonia while emphysema is difficult to diagnose, as they are defined only in radiography (auscultatory difficult to catch moist rales in the background masking their wheezing). Thermal response erased hypothermia inherent emphysema (especially in heart failure). Therefore, at the slightest suspicion of the infection should apply the appropriate treatment. The most advantageous combination oral or parenteral antibiotic treatment with aerosol. It is recommended that treatment with bronchodilators (spasms of bronchial tubes).
In resistant cases, even without explicit asthma attacks, a good effect gives steroid therapy: for example, prednisone in the dose of 10-30 mg, with a gradual decrease of 2.5 mg every other day and stopping after the achieved effect.
The great value has the timely use of means salt. They should provide the patient every 2 hours. More effective than other potassium iodide (2 to 3 grams per day), which provide for 2-4 days with intervals of 3-4 days, and ammonium chloride in the same doses. Drinking plenty of fluids, especially in hot liquids (breast tea), increases sweating increases secretion bronchial glands, liquefies phlegm. Expectorant effect gives steam inhalation. The great value has therapeutic exercises. Its goal is to increase the amplitude of respiration by deepening exhalation and reduce the residual air. This contributes to the increase of pressure in the trachea and major bronchi during exhalation, reducing the pressure difference between the alveoli and large bronchi and prevents the valve mechanism. Patients themselves often come to this: "puffing", put his lips as for whistling. This is based on different types of breathing exercises in bronchial asthma and emphysema (singing, whistling).
The use of oxygen shown in all cases of emphysema, where the compensatory mechanisms do not provide sufficient saturation of blood with oxygen; however, high oxygen concentration may cause irritation of the bronchial tubes and strengthening of bronchospasm. When using oxygen tents should be aware of the danger of accumulation of carbon dioxide and to control its content in the air we breathe. With advanced respiratory failure, when significantly suppressed sensitivity of the respiratory centre to carbon dioxide and breathing is supported mainly due sinocarotidna reflex, increasing the concentration of dissolved in the plasma of oxygen can lead to a reduction in respiratory excursions with the accumulation of carbon dioxide, and then to hypercapnic coma or respiratory arrest. Therefore, treatment should be undertaken only under the supervision of a physician with a mixture containing 40-50% humidified oxygen, intermittently cycles of increasing the duration (10-20-30 minutes). Shows the simultaneous use of means of inciting the respiratory center: kordiamin 2-4 ml intramuscularly and (slow) intravenously every 2 to 4 hours or better korazol 1-2 ml intramuscularly or (slow) intravenously.
Emphysema of the lungs without the Express cardiopulmonary syndrome in the absence of circulatory failure shows the treatment in the sanatoriums on climatic seaside, mountain and forest (lowland) resorts. On resorts of the Baltic sea patients with emphysema should be sent only in the summer. Treatment in the local suburban specialized sanatoriums (outside resorts) shows patients with lung diseases of non-tuberculosis character, and the related emphysema.
Surgical treatment. In 1926 Reich (L. Reich) proposed the imposition of pneumoperitoneum for therapeutic purposes. Physiological basis of this method is to increase the pressure under the diaphragm; as a result aperture rises, increasing its tours and decreases the amount of residual air. Intraperitoneally injected first 400-500 ml of air in a few days-800-1000 Jr. Supports PCI produced within 1-2 weeks. The pressure in the abdominal cavity support at the level of 9-12 cm of water. Art. In rare cases, there may be serious complications - intestinal perforation. The effect was good, but temporary. Contraindications cardiac failure, bronchial asthma, acute exacerbation of chronic bronchitis. More sustainable effect is achieved by defragmentarea by A. G. Savinykh.
Prevention. Due to the leading values in the pathogenesis of emphysema, chronic bronchitis, especially the defeat of small bronchi, the basis of prevention should be the first treatment of acute and chronic bronchitis (see). Hence the importance of functional diagnostics of respiratory function during normal "cold" bronchitis.