Emphysema Assignment

Access the profile card for user: Jettie Leger Jettie Leger

RE: Over 65 Years of Age - Emphysema Attachment

Collapse

Jonathan,

The impact of Emphysema and COPD took the life of my best friend of 20 years on 30 January 2017 at the age of 64. As I sit here tonight in a hotel on my way to her funeral, I could not help but stop and read your post. Eleven years ago when she was diagnosed she continued to smoke until six years ago when an exacerbation placed her in the hospital for three weeks on a ventilator. After this event she stopped smoking and began attending pulmonary rehab, but over the last year the impact of smoking since she was 14 took its toll. On the second of November she was the recipient of a bilateral

I have not summarized the content, instead I have copied and pasted it directly. Perhaps as nurses we can impart the gravity of the risk of smoking not just for the smoker but for those left behind without answers.

While Bilateral Lung Transfer is increasingly performed for all native lung diseases4, debate continues as to the optimal transplant procedure of choice in the emphysema population as discussed in detail below.

Post-transplant exercise ability appears to be restricted primarily by aerobic capacity due to skeletal muscle dysfunction, not by ventilatory limitations. Although the specific cause of skeletal muscle dysfunction is unclear, deconditioning due to underlying chronic disease, post-transplant immunosuppressant use, and compromised nutrition could

As a consequence of the transplant procedure itself, many innate protective responses are interrupted. The transplanted lungs are dennervated resulting in impaired cough reflex and abnormal mucocilliary clearance mechanisms These disruptions, in addition to the need for high levels of immunosuppression, culminate in increased infection risk predisposing to viral (most importantly cytomegalovirus), bacterial, and fungal infections19. Chronic exposure to immunosuppressive medications also leads to metabolic dysregulation resulting in increased risk of hypertension, hyperlipidemia, diabetes and cardiovascular disease. Chronic renal insufficiency also occurs in most patients and a subset go on to develop frank renal failure over time as a result of calcineurin inhibitor