Emphysema Compensatory

Compensatory pulmonary emphysema (e. pulmonum compensatorium) is a chronic lung disease characterized by stretching and destruction of the alveoli, which leads to an increase in lung volume.

Reasons for the development of compensatory emphysema:

1. Chronic diseases of the bronchi and lungs (chronic bronchitis, bronchial asthma, tuberculosis, etc.), accompanied by impaired bronchial obstruction. As a result, hyperinflation of the lungs develops to compensate for impaired gas exchange.
2. Increased physical activity, accompanied by deep and frequent breathing (among athletes, wind musicians).

Symptoms of compensatory emphysema:

1. Shortness of breath during exercise due to impaired gas exchange.
2. Increase in chest volume.
3. Strengthening and lengthening exhalation.
4. Decreased elasticity of lung tissue.

Diagnosis is based on medical history, clinical picture, results of laboratory and instrumental studies (spirometry, chest x-ray).

Treatment of compensatory emphysema consists of treating the underlying disease that led to its development and quitting smoking. Bronchodilators, mucolytics, and anti-inflammatory drugs may be prescribed. Breathing exercises, physical therapy, and outdoor sports are important.

Article "Compensated pulmonary emphysema"

*Compensatory emphysema* is a phenomenon in which the air in the lungs becomes more than normal, but due to the compensatory capabilities of the respiratory system, the degree of inspiratory shortness of breath at rest is insignificant or completely absent. Compensation for pulmonary emphysema is facilitated by altered properties of the mucous membrane of the trachea and bronchioles, and the compliance of the lungs. Based on normal gas exchange, the hemodynamics of the respiratory organs are disrupted. Since hyperairiness is a spontaneous compensation of the primary pathological process, the phenomenon is not constant and varies depending on the development mechanism. But there is a constant symptom of the disease - persistent shortness of breath of a mixed type (expiratory due to impaired ventilation of large bronchi-capillaries and inspiratory during the exhalation stage due to the inability to completely pump out air from the alveoli). It is important to know that compensatory reserves are significantly reduced in children due to the structural features and development of the respiratory system (the predominance of bronchioles in relation to the trachea and bronchi of an adult), the high physiological reactivity of the morphofunctional systems of the body, as well as the functional immaturity of organs and systems in general. Hyperinflation in compensated emphysema occurs more often due to impaired bronchial obstruction and, to a lesser extent, due to non-closure of the alveolar merocellular septa. According to the mechanism of development, emphysematous fields with anatomical compensation are usually large in area and areola, the air spaces are evenly distributed, and are not often overlapped by alveolar septa. Small and medium-sized vessels dilate moderately. As a result, a pulmonary lump is formed over the focus of hyperinflation, which is recorded on a chest x-ray, and the frontal paraseptal shadow is recorded. Under the influence of provoking factors (protracted deep cough, overstrain of the respiratory apparatus when lifting heavy objects, diving to great depths and other physical efforts, intoxication, cooling or overheating of the body), non-inspiratory paradoxical episodes may appear, and then the symptoms of emphysema weaken or disappear for some time before the formation reverse pathogenetic process (exhaustion of the compensatory capabilities of the lung tissue and the resumption of an increase in signs of hyperinfusion). It is unfavorable external factors or low resistance