Biomaterial Database

Anesthesia for patients with severe chronic obstructive pulmonary disease. 2010

Thomas Edrich, and Nicholas Sadovnikoff

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. tedrich@partners.org

OBJECTIVE Patients with chronic obstructive lung disease experience an increased risk of perioperative pulmonary complications. This review presents an evidence-based approach to perioperative care designed to optimize management. RESULTS Recent research has provided guidance regarding intraoperative and postoperative administration of oxygen and the selective use of volatile agents. The significance of preoperative malnutrition and postoperative epidural analgesia on outcomes has also been explored further. The opportunity for anesthesiologists to engage in tobacco interventions and the benefits of addressing smoking cessation have been studied. CONCLUSIONS Optimization for surgery includes preoperative treatment of reversible airway obstruction and respiratory infections, smoking cessation, and possibly nutritional interventions. Meticulous intraoperative monitoring combined with a sound understanding of pathophysiological mechanisms underlying air trapping will help clinicians strike a balance between permissive hypercapnia and adequate ventilation.

UI	MeSH Term	Description	Entries
D011300	Preoperative Care	Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)	Care, Preoperative,Preoperative Procedure,Preoperative Procedures,Procedure, Preoperative,Procedures, Preoperative
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000402	Airway Obstruction	Any hindrance to the passage of air into and out of the lungs.	Choking,Airway Obstructions,Obstruction, Airway,Obstructions, Airway
D000768	Anesthesia, General	Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.	Anesthesias, General,General Anesthesia,General Anesthesias
D000776	Anesthesiology	A specialty concerned with the study of anesthetics and anesthesia.
D016343	Monitoring, Intraoperative	The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs).	Intraoperative Monitoring
D019317	Evidence-Based Medicine	An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)	Medicine, Evidence-Based,Evidence Based Medicine,Medicine, Evidence Based
D029424	Pulmonary Disease, Chronic Obstructive	A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.	Airflow Obstruction, Chronic,COAD,COPD,Chronic Airflow Obstruction,Chronic Obstructive Airway Disease,Chronic Obstructive Lung Disease,Chronic Obstructive Pulmonary Disease,Chronic Obstructive Pulmonary Diseases,Airflow Obstructions, Chronic,Chronic Airflow Obstructions