Anesthesia in lung pathologies
The educational algorithm Anesthesia in lung pathologies offers the possibility of solving two cases of different pulmonary diseases. Specifically, it is a patient with COPD and a patient with IPF, ie. a restrictive lung disease. The aim of the algorithm is to emphasize the importance of preoperative patient preparation and at the same time to point out possible complications and their subsequent solution, which may occur in patients with lung disease.
Review
Chronic lung diseases have an increasing frequency and severity worldwide. Therefore, we will encounter them more often during our clinical practice. Although these are primarily lung diseases, they have significant extrapulmonary effects and these must also be kept in mind during the care of patients with lung disease. Based on the dominant lung involvement, chronic lung disease can be divided into obstructive and restrictive, or mixed. To put it simply, the obstructive type of disorder is a reduced patency of the bronchial tree and a restrictive disorder is a reduction in the area of the lungs where the gas exchange takes place, with a concomitant decrease in lung compliance. For this reason, the anesthesiological approach in the perioperative period in patients with some type of lung disease is also different. In this algorithm, COPD ( Chronic obstructive pulmonary disease ) was selected for the group of obstructive diseases and IPF( Idiopathic pulmonary fibrosis ) was selected for the group of restrictive diseases. In both branches of the algorithm, the most significant differences are emphasized both in the preoperative preparation and in the management of anesthesia itself (pharmacotherapy, lung ventilation ).
Sources
LARSEN, Reinhard. Anestezie. Ed. 2nd Czech. Translated Jarmila DRÁBKOVÁ. Praha: Grada, 2004. ISBN 80-247-0476-5.
MYERS, Katie, et al. Stopping smoking shortly before surgery and postoperative complications: a systematic review and meta-analysis. Archives of internal medicine [online], 2011, 171.11: 983-989 [cit. 2020-03-23]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21403009
DUGGAPPA, Devika Rani; RAO, G. Venkateswara; KANNAN, Sudheesh. Anaesthesia for patient with chronic obstructive pulmonary disease. Indian journal of anaesthesia [online], 2015, 59.9: 574 [cit. 2020-03-23]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613404/
GRUENBAUM, Shaun; KURUP, Viji; HOLLINGSWORTH, Helen. Anesthesia for patients with interstitial lung disease or other restrictive disorders. [online], [cit. 2020-03-23]. Available at: https://www.uptodate.com/contents/anesthesia-for-patients-with-interstitial-lung-disease-or-other-restrictive-disorders?search=Lung%20Compliance&source=search_result&selectedTitle=7~126&usage_type=default&display_rank=7
