Modern concepts in the management of emphysema in the aged and infirm.

Abstract

The haphazard method of treating patients seriously ill with emphysema is gradually being replaced by modern, well organized cardiopulmonary therapeutic and rehabilitation programs. This evolution is the result of a further expansion in our knowledge of cardiopulmonary physiology and biochemistry; an additional factor is the recent public awareness of the seriousness of the problem, brought about by public educational programs. Emphysema is chiefly a disease of old age. It develops as a result of a degenerative process in which the alveolar walls become thinner and the lungs less elastic. Senile emphysema per se may not be disabling, but it is often associated with a severe chronic pulmonary disorder and thus can become the most distressing disease of old age, with shortness of breath even on such slight exertion as dressing or talking. Disturbances in cardiopulmonary physiology due to obstruction in the free flow of air and to superimposed infections require the use of all available procedures designed to obtain maximal pulmonary ventilation. The magnitude, the difficulty and the many controversial aspects of this problem are evident. The eventual solution will come gradually with continued interest and research.