CHRONIC PULMONARY DISEASES_ASTHMA, EMPHYSEMA & CHRONIC BRONCHITIS PPT

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Compare/contrast the difference between asthma, emphysema & chronic bronchitis
List 3 anesthetic strategies in caring for this population
Identify 3 pre operative tests  desired for anesthesia screening
Describe intraoperative planning for postoperative recovery in this population

ASTHMA-what is it?
Chronic, inflammatory disease
Reversible obstruction (to a degree)
Increased airway reactivity
Most common chronic illness in children under 17 years
Complex; involves inflammatory cells,mediators, cells&tissues residing in the airway

ASTHMA-early response
Immed bronchospasm on exposure
Symptoms occur in 10-20 min
Resolves in 60-90 min
Antigen binds to IgE “coated” mast cells,bronchospasm .
Reversible with B2 agonist inhalers

ASTHMA-Late Response
Onset 3-5 hrs after exposure
Involves inflammation&inc. airway reactivity
May begin cycles of exacerbation
Chronic inflammation leads to airway remodeling, which limits reversibility degree

CARDIAC ASTHMA
Due to heart failure
Chronic, nonproduct cough-becomes worse when supine(autotransfusion effect)
Bronchospasm occurs b/o congestion of the bronchial mucosa

EMPHYSEMA-what is it?
Loss of lung elasticity, abnormal permanent enlargement of air spaces distal to term bronchioles with distention of alveolar walls &

capillary beds without obvious fibrosis
Alpha1-antitrypsin normally protects lung against destruction caused by inflammatory cells-diminished in this disease

CHRONIC BRONCHITIS or Blue Bloaters
Inflammation of major & small airways.  Edema & hyperplasia of submucous glands with inc. mucous production.  Chronic cough (3 mos) for at least 2 consecutive years in the absence of other diseases


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