2 Indications and current treatments
2.1 Emphysema is a chronic lung disease in which the walls of the air sacs (alveoli) in the lungs weaken and disintegrate. This leaves behind abnormally large air spaces that stay filled with air even when the patient breathes out. The most common symptoms of emphysema are shortness of breath, coughing, fatigue and weight loss. Recurrent illnesses (such as chest infections) often lead to exacerbations, for which patients may need hospitalisation. Emphysema is usually smoking related but may also be inherited.
2.2 Treatment options include pulmonary rehabilitation (exercise training, breathing retraining, and patient and carer education), smoking cessation, and the use of inhaled or oral bronchodilators and corticosteroids. Oxygen therapy may also be indicated in more severe cases. Lung volume reduction surgery is an option for patients who experience breathlessness, and whose pulmonary function test results show severe obstruction and enlarged lungs. Such surgery can be done thoracoscopically (using video-assisted thoracoscopy or thoracotomy) or using an open approach (using a sternotomy or thoracotomy). Lung transplantation surgery may also be an option. Certain therapies under clinical investigation such as coiling, use of sealants and thermal ablation may be used in regional lung disease.