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• W2007998103 abstract "Numerous disease processes may lead to advanced lung disease. The pathophysiology and mechanisms of lung injury may differ, but the symptoms and results are often similar. Advancing lung disease, when left unchecked, leads to disabling dyspnea, with or without associated symptoms of cough, sputum, wheezing, chest discomfort, and hemoptysis. Lung transplantation for end–stage lung disease remains the ultimate therapeutic intervention to reverse what is often otherwise irreversible. The goals of lung transplantation are aggressive: Restore normal lung function, restore normal exercise capacity, prolong life, and limit morbidity from the procedure and immunosuppressive medications. Unfortunately, stringent patient selection criteria and limited availability of organs limit this option to a small proportion of individuals with end–stage lung disease. Lung volume reduction surgery has been proposed as a surgical intervention for the most common cause of end–stage lung disease—chronic obstructive pulmonary disease (COPD)—but the goals of lung volume reduction surgery are somewhat more modest. The goals of that procedure are palliative, consisting of relief of symptoms and improvement of exercise capacity (Table 1). Future studies will determine whether life span is improved by that procedure. Once again, the surgical approach is limited to a minority of individuals with end–stage lung disease. Pulmonary rehabilitation represents a comprehensive approach to the management of advanced lung disease that is applicable to virtually all affected individuals. Although cost–benefit studies comparing surgical intervention and pulmonary rehabilitation have not addressed the optimal approach, it is clear that transplantation is associated with a cost far exceeding the other two options and that lung volume reduction surgery is likely a more expensive option than pulmonary rehabilitation. The goals of pulmonary rehabilitation, according to the American Thoracic Society,1 are: “(1) to lessen airflow limitation, (2) to prevent and treat secondary medical complications such as hypoxemia and infections, and (3) to decrease respiratory symptoms and improve quality of life.” With the advent of the aforementioned surgical options, the role of pulmonary rehabilitation undertakes a fourth major goal not addressed in the American Thoracic Society statement. Its goal prior to surgical intervention is to optimize physical and emotional health on the assumption that the intervention will improve the likelihood of a positive outcome. After surgical intervention, pulmonary rehabilitation might serve to enhance the benefits resulting from successful surgery. An overview of pulmonary rehabilitation is provided in this article. The role of pulmonary rehabilitation associated with lung transplantation and lung volume reduction surgery is reviewed." @default.
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• W2007998103 date "1997-06-01" @default.
• W2007998103 modified "2023-09-27" @default.
• W2007998103 title "PULMONARY REHABILITATION AND SURGERY FOR END–STAGE LUNG DISEASE" @default.
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• W2007998103 doi "https://doi.org/10.1016/s0272-5231(05)70370-1" @default.
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