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COPD and anaesthesia

Beschreibung

Respiratory medicine Mindmap am COPD and anaesthesia, erstellt von kavi am 30/08/2013.
kavi
Mindmap von kavi, aktualisiert more than 1 year ago
kavi
Erstellt von kavi vor etwa 11 Jahre
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Zusammenfassung der Ressource

COPD and anaesthesia
  1. The problem
    1. Serious comorbidity
      1. Long term mortality of patients with SEVERE COPD having ANY surgery is 47% over 2 years.
        1. At risk for serious postoperative complications, esp pulmonary.
        2. The solution(s)
          1. Preop optimisation, risk identification, and appropriate anaesthetic management.
        3. Pathophysiology of COPD
          1. Inflammation
            1. Inhaled cigarette smoke
              1. Airflow limitation that isn't fully reversible
              2. Inflammation of small airways - bronchitis/bronchiolitis
                1. Plus parenchymal destruction - emphysema

                  Anmerkungen:

                  • Contribution of the two processes varies between individuals.
              3. Small airways disease
                1. Air trapping and obstruction
                  1. Chronically and dynamically under stress
                    1. Affects V/Q mismatching and the loading of the resp muscles
                2. Emphysema
                  1. Decreases gas transfer
                    1. Reduces the pulmonary capillary bed
                      1. Worsens the V/Q mismatching
                    2. Reduces the support of small airways
                      1. Exaccerbates the small airways disease
                    3. End result of V/Q mismatching, alveolar hypoventilation, and decreased gas transfer
                      1. Hypoxia ± hypercarbia
                        1. Hyperinflation leads to dyspnoea without hypoxaemia
                      2. Extra pulmonary disease
                        1. Related to COPD
                          1. Cor pulmonale
                            1. Respiratory and skeletal muscle wasting
                            2. Other
                              1. CVD that is common in this population
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