Physiologic basis for improved pulmonary function after lung volume reduction

Henry E. Fessler, Steven M. Scharf, Edward P. Ingenito, Robert J. McKenna, Amir Sharafkhaneh

Research output: Contribution to journalReview article

Abstract

It is not readily apparent how pulmonary function could be improved by resecting portions of the lung in patients with emphysema. In emphysema, elevation in residual volume relative to total lung capacity reduces forced expiratory volumes, increases inspiratory effort, and impairs inspiratory muscle mechanics. Lung volume reduction surgery (LVRS) better matches the size of the lungs to the size of the thorax containing them. This restores forced expiratory volumes and the mechanical advantage of the inspiratory muscles. In patients with heterogeneous emphysema, LVRS may also allow space occupied by cysts to be reclaimed by more normal lung. Newer, bronchoscopic methods for lung volume reduction seek to achieve similar ends by causing localized atelectasis, but may be hindered by the low collateral resistance of emphysematous lung. Understanding of the mechanisms of improved function after LVRS can help select patients more likely to benefit from this approach.

Original languageEnglish (US)
Pages (from-to)416-420
Number of pages5
JournalProceedings of the American Thoracic Society
Volume5
Issue number4
DOIs
StatePublished - May 2008

Keywords

  • Airflow limitation
  • Emphysema surgery
  • Lung mechanics
  • Lung recoil
  • Respiratory muscles

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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