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18 Cards in this Set
- Front
- Back
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What are the three types of Restrictive Lung disease?
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Intrinsic
Extrinsic Muscular |
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Examples of Intrinsic Restrictive Lung Disease?
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Acute:
ARDS Aspiration pneumonitis Opiod overdose CHF High Altitude Chronic: Sarcoidosis Alveolar proteinosis Drug-induced pulm fibrosis |
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Examples of Extrinsic Restrictive Lung Disease?
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Obesity
Pregnancy Ascites Scoliosis Flail chest |
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Examples of Muscular Restrictive Lung Disease?
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Myasthenia Gravis
Guillain-Barre Eaton-Lambert Muscular dystrophies |
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What are the characteristics of Restrictive Lung Disease?
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1. Decrease in all lung volumes
(except Fev1/FVC= nl or inc) 2. Decreased lung compliance 3. preservation of expiratory flow rates |
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What is the ventilation management in a patient with restrictive lung disease?
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Decrease TV with Inc RR
Add PEEP to inc FRC Adequate FiO2 (too high can cause fibrotic changes) |
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Characteristics of Restrictive Lung disease?
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Increase in elastic recoil
Poor lung compliance Decreased FRC Right HF/ Pulm HTN True diffusion gradient |
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Intraoperative /anesthetic considerations with Chronic restrictive disease?
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*Small FRC- so tolerate anea poorly
*Uptake of Inhaled anesth is faster *Keep Peak airway pressures low |
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Examples of Obstructive Lung diseases?
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Asthma
Emphysema Bronchitis COPD |
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Description of Asthma?
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chronic airway inflammation, with reversible expiratory airway obstruction in response to various stimuli and bronchial hyperreactivity
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Flow volume loop of asthma?
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show characteristic downward scooping of the expiratory limb.
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What test is a direct measure of the severity of expiratory airflow obstruction(asthma)?
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FEV1 and FEF (<60% of expected is considered moderate; < 35% considered severe)
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Characteristics of emphysema (OBS LD)?
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Blebs -increased deadspace, Expiratory obstruction to airflow.
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What are the two types of emphysema?
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1. centri-acinar: Central lobular, dilated bronchioles.
2. Pan-acinar: Bullous emphysema, affects the entire lobule |
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PFT's characteristic of OB Lung disease?
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Increases in FRC,TLC, RV, ERV, except for FEV1=decreased, FEV1/FVC=dec
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Anesthesia considerations for OBS lung disease?
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Pretreat with
-B2-Agonists,(vasodilate) -Lidocaine (blunt airway reflexes) -Avoid pentathol- Propofol better -Avoid Nonsel BBlockers- can decrease cAMP= bronchoconstriction -Avoid Nitrous Oxide- may increase bullous. |
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What is the best ventilation mode for ObStructive Disease?
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Low Insp Flows(Dec airway turbulence)
TV 10-12cc/kg w/ slower RR Longer Exp times 1:2.5- 1:3 |
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What can be the cause of wheezing other than asthma?
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Kinked ETT
Light anesthesia R mainstem intubation Tension Pneumothorax |
