- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Part 4.1 Physiology
- Part 4.2 Respiratory monitoring
- Part 4.3 Upper airway obstruction
- Part 4.4 Airway access
- Part 4.5 Acute respiratory failure
- Part 4.6 Ventilatory support
- Part 4.7 Weaning ventilatory support
- Part 4.8 Extracorporeal support
- Part 4.9 Aspiration and inhalation
- Part 4.10 Acute respiratory distress syndrome
- Part 4.11 Airflow limitation
- Chapter 110 Pathophysiology and causes of airflow limitation
- Chapter 111 Therapeutic approach to bronchospasm and asthma
- Chapter 112 Therapeutic strategy in acute or chronic airflow limitation
- Part 4.12 Respiratory acidosis and alkalosis
- Part 4.13 Pneumonia
- Part 4.14 Atelectasis and sputum retention
- Part 4.15 Pleural cavity problems
- Part 4.16 Haemoptysis
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 505) Airflow limitation
Exacerbations of asthma or chronic obstructive pulmonary disease (COPD) can be life-threatening emergencies, and require careful management to minimize the risks of morbidity and mortality. Prompt, full bronchodilator therapy, careful observation and appropriate mechanical ventilation technique is required. Dynamic hyperinflation of the lungs occurs in all patients, and must be careful assessed and regulated. Excessive dynamic hyperinflation can result in respiratory tamponade, hypotension, circulatory failure, pneumothoraces and, in severe cases, cardiac arrest. Intravenous or continuous nebulized salbutamol commonly causes lactic acidosis that should be detected and managed. Prolonged paralysis during difficult mechanical ventilation can result in severe necrotizing myopathy. Pneumothoraces in ventilated patients with asthma are usually under tension, redistribute ventilation to the contralateral lung, and risk a second tension pneumothorax. Patients surviving mechanical ventilation for asthma and COPD have an increased risk of recurrence and death. All these problems require awareness, avoidance or detection and management
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Part 4.1 Physiology
- Part 4.2 Respiratory monitoring
- Part 4.3 Upper airway obstruction
- Part 4.4 Airway access
- Part 4.5 Acute respiratory failure
- Part 4.6 Ventilatory support
- Part 4.7 Weaning ventilatory support
- Part 4.8 Extracorporeal support
- Part 4.9 Aspiration and inhalation
- Part 4.10 Acute respiratory distress syndrome
- Part 4.11 Airflow limitation
- Chapter 110 Pathophysiology and causes of airflow limitation
- Chapter 111 Therapeutic approach to bronchospasm and asthma
- Chapter 112 Therapeutic strategy in acute or chronic airflow limitation
- Part 4.12 Respiratory acidosis and alkalosis
- Part 4.13 Pneumonia
- Part 4.14 Atelectasis and sputum retention
- Part 4.15 Pleural cavity problems
- Part 4.16 Haemoptysis
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care