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Respiratory ageing 

Respiratory ageing
Chapter:
Respiratory ageing
Author(s):

Jaume Canet

and Joaquin Sanchis

DOI:
10.1093/med/9780199604999.003.0007
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date: 18 August 2019

This chapter reviews respiratory system changes due to ageing that are of most relevance to anaesthetists. Structural changes in the chest wall, bony and cartilaginous, are usually because of loss of elasticity. Kyphosis is a more common change, in which the thorax becomes round with a less-compliant chest wall and reduced functional residual capacity. The diaphragm falls in height, thereby reducing its ability to generate force. Lung parenchymal changes are largely because of loss of elasticity leading to alveolar degeneration, increasing air trapping, and reduced clearance of surface material from the small airways. Over the age of 65, lung function may deteriorate and closing capacity may encroach into tidal breathing when supine. Gas exchange, lung perfusion, resting plasma oxygen values with ageing, changes in upper airway and central regulation leading to the prevalence of sleep-disordered breathing and reduced response to hypoxia and hypercarbia are described.

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