[Pathophysiology and management of pulmonary emphysema]

The predominant physiological abnormalities of pulmonary emphysema are chronic airway obstruction, hyperinflation of the lung, decrease of lung elastic recoil, and impaired gas exchange. Patient who still smokes must be advised and supported in an effort to stop smoking before medical treatment. The treatment goals are to induced bronchodilation, decreased the inflammatory change and promote expectoration to prevent the progressive deterioration in lung function and improves quality of life. Inhaled beta 2-agonists, anticholinergics, and oral theophylines, as bronchodilators improved exertional dyspnea and exercise tolerance. Inhaled and oral corticosteroids have an anti inflammatory effect for chronic airway inflammation. Comprehensive respiratory treatments including home oxygen therapy and rehabilitation are also successfully applied for these patients.