Relation between Preoperative Inspiratory Lung Resistance and the Outcome of Lung-Volume–Reduction Surgery for Emphysema

Chronic obstructive pulmonary disease, which is estimated to affect 14 million persons in the United States, is “characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema.” 1 In chronic bronchitis, airflow is obstructed by inflammation and edema of the airway, hypersecretion of mucus, and constriction of bronchial smooth muscle. In emphysema, airflow is obstructed by the loss of elastic recoil and diminished airway tethering as a result of parenchymal destruction. In recent years, surgery to reduce lung volume has been reintroduced to alleviate dyspnea and improve exercise tolerance in selected patients with emphysema. 2 This operation, first suggested . . .