Emphysema, lung volume reduction and anaesthesia

Emphysema is a leading cause of global mortality, and likely to remain so due to continued tobacco smoking. Medical treatment of emphysema may alleviate symptoms but does little to slow disease progression. Lung volume reduction aims to reverse some of the pathophysiological changes such as reducing chest hyperexpansion to improve respiratory muscle function and reducing residual volume to improve the function of adjacent lung tissue. Surgical lung volume reduction is effective for symptomatic relief but carries significant perioperative morbidity. Bronchoscopic techniques of lung volume reduction are now being developed. Anaesthesia for patients having lung volume reduction is challenging, and requires meticulous perioperative care and management of complex intraoperative interventions such as one-lung ventilation or prolonged bronchoscopic procedures. (C) 2012 Elsevier Ltd. All rights reserved.