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COPD and anaesthesia

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Respiratory medicine Mind Map on COPD and anaesthesia, created by kavi on 30/08/2013.
kavi
Mind Map by kavi, updated more than 1 year ago
kavi
Created by kavi almost 11 years ago
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Resource summary

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

                  Annotations:

                  • 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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