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MEDICAL: Chronic Obstructive Pulmonary Disease

Emphysema is a chronic obstructive pulmonary disease (COPD) that is characterized by abnormal, permanent enlargement of the air spaces past the terminal bronchioles, which results in the destruction of respiratory walls. The syndrome includes both chronic bronchitis and emphysema. COPD affects almost 15 million people and is the fourth leading cause of death overall in the United States. Approximately 5% to 6% of male adults and 1% to 3% of female adults have emphysema.

Emphysema DRG CategoT

Mean LOS: Description:

In emphysema, the affected terminal bronchioles contain mucous plugs that, when they are enlarged, eventually result in the loss of elasticity of the lung parenchyma, thus causing difficulty in the expiratory phase of respiration. The alveolar walls are destroyed by abnormal levels of enzymes (proteases) that break down respiratory walls. Gas exchange is impaired by the reduced surface area that results from the destruction of alveolar walls.

Four types of emphysema have been identified: paraseptal emphysema, which affects the periphery of the lobule; panacinar or panlobular emphysema, which affects the lower anterior segments or the entire lungs; centriacinar or centrilobular emphysema, the most common form, which destroys respiratory bronchioles and is associated with chronic bronchitis and cigarette smoking; and bronchiectasis or chronic necrotizing infection that leads to abnormal and permanent bronchial dilation, which occurs rarely. Complications from emphysema include cor pul-monale, respiratory failure, pneumothorax, and recurrent respiratory tract infections. Emphysema is the most common cause of death from respiratory disease in the United States.

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