Anesthesia For Patients With Resp Disease Flashcards
Two strongest predictors of complications in people with respiratory disease:
The two strongest predictors of complications seem to be operative site and a history of dyspnea, which correlate with the degree of preexisting pulmonary disease.
Operations near diaphragm can cause:
Operations near the diaphragm often result in diaphragmatic dysfunction and a restrictive ventilatory defect
T/F-the Risk of postoperative pulmonary dysfunction increases with a thoracotomy or laparotomy even if there is no previous disease.
TRUE
Primary characteristic of obstructive lung disorders:
The primary characteristic of these disorders is resistance to airflow
FEF 25-75 and FEV in patients with Obstructive disorders
An MMEF of <70% (forced expiratory flow [FEF25-75%]) is often the only abnormality early in the course of these disorders. Values for FEF25-75% in adult males and females are normally >2.0 and >1.6 L/sec, respectively. As the disease progresses, both forced expiratory volume in 1 sec (FEV1) and the FEV1/FVC (forced vital capacity) ratio are less than 70% of the predicted values.
Pathophysiology for COPD: or all obstructive patterns
Elevated airway resistance and air trapping increase the work of breathing; respiratory gas exchange is impaired because of ventilation/perfusion Image not available. imbalance. The predominance of expiratory airflow resistance results in air trapping; residual volume and total lung capacity (TLC) increase.
Vagal response in the bronchi.
Vagal afferents in the bronchi are sensitive to histamine and multiple noxious stimuli, including cold air, inhaled irritants, and instrumentation (eg, tracheal intubation). Reflex vagal activation results in bronchoconstriction, which is mediated by an increase in intracellular cyclic guanosine monophosphate (cGMP).
After an attack-which sized airways get better faster?
As an attack resolves, airway resistance normalizes first in the larger airways (main-stem, lobar, segmental, and subsegmental bronchi), and then in more peripheral airways.
What does a normal or high PaCO2 mean in patients with Asthma?
normal or high Paco2 indicates that the patient can no longer maintain the work of breathing and is often a sign of impending respiratory failure. A pulsus paradoxus and electrocardiographic signs of right ventricular strain (ST-segment changes, right axis deviation, and right bundle branch block) are also indicative of severe airway obstruction.
What does B2 do for bronchoconstriction?
Activation of β2-adrenergic receptors on bronchiolar smooth muscle stimulates the activity of adenylate cyclase, which results in the formation of intracellular cyclic adenosine monophosphate (cAMP)
