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Restrictive lung disease

Causes of restrictive pulmonary pathology

Causes of acute restrictive pathology:

•????pulmonary edema;

• ???? ARDS;


• ???? neurogenic edema;

• ???? overdose of opioids;

• ???? congestive myocardial failure;

• ???? pleural effusion;


• ???? an increase in the mediastinum;

• ???? pneumomediastinum.

Chronic lung disease leading to restrictive disorders

• ???? Sarcoidosis.

• ???? Pneumonitis.

• ???? Eosinophilic granuloma.

• ???? Alveolar proteinosis.

• ???? Fibrosis of the lungs.

Chronic extrapulmonary pathology leading to restrictive disorders


• ???? Ascites.


• ???? Kyphoscoliosis ankylosing spondylitis.

• ???? Chest deformity.

Neuromuscular disorders

• ???? Damage to the spinal cord.

• ???? Guillan — Barre Syndrome (acute primary idiopathic polyradiculoneuritis).

• ???? Myasthenia gravis.

• ???? Eaton — Lambert Syndrome.

• ???? Muscular dystrophy.

• ???? Pleural fibrosis.

• ???? "Dangling" chest.

Restrictive lung disease and anesthesia

• ???? Lung extensibility reduced.

• ???? Pulmonary volumes are reduced, but FEV1 / FVC remains normal.

• ???? Increased respiration work.

• ???? The ability to efficiently cough and remove sputum is reduced.

• ??? High risk of postoperative pulmonary complications.

• ???? In acute lung diseases leading to restrictive changes, planned operations are postponed.

• ???? Acute surgical pathology in combination with acute lung disease is a critical condition.

• ???? In preparation for emergency surgery, it is necessary to maximize oxygenation and ventilation by actively treating concomitant pathologies (relief of pulmonary edema, treatment of heart failure, removal of pleural effusion or ascitic fluid, etc.).

• ???? The choice of anesthetic is not critical.

• ???? Mechanical ventilation with reduced lung extensibility is characterized by high peak inspiratory pressure, which increases the risk of barotrauma.
Airway pressure should not exceed 40 cm H2O. Tidal volume is reduced to 8-10 ml per kg, increasing the frequency by compensating (up to 14-18 per minute).

• ???? Often there is a need for high FiO2 in the respirable mixture and PEEP.

• ???? In severe adult respiratory distress syndrome for mechanical ventilation it is advisable to use respirators specially designed for work in the ICU, rather than anesthesia machines that do not provide the necessary ventilation mode in these patients.
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Restrictive lung disease

  1. Restrictive lung disease
    Restrictive diseases are characterized by a decrease in lung distensibility. Pulmonary volumes are below normal, while the volumetric flow rate on the exhale is not reduced. Thus, FEV1 and FVC are reduced, but the ratio of FEVc / FVC remains normal. Restrictive diseases include many acute and chronic pathological conditions of the lungs, as well as lesions of the pleura, chest wall, diaphragm and
  2. Obstructive and restrictive pulmonary diseases
    There are two types of diffuse lung lesions. These are obstructive processes that affect mainly the airways and are characterized by an increase in resistance to air passage due to partial or complete obstruction at any level (from the trachea to respiratory bronchioles), and restrictive processes, which are characterized by a decreased expansion of the lung parenchyma during inspiration and,
  3. Diffuse interstitial (infiltrative and restrictive) lung diseases
    In this section of the chapter, a combined group of noncommunicable diseases is described, characterized mainly by diffuse and usually chronic changes that affect mainly the stroma of the lungs, i.e. interstitial tissue of the alveolar walls, consisting of the basement membrane of the endothelium and epithelial cells, collagen fibers, elastic structures, proteoglycans, fibroblasts,
  4. Chronic diffuse inflammatory diseases of the lungs. Bronchial asthma. Lungs' cancer. Pneumoconiosis
    1. The main types of diffuse lung lesions 1. interstitial 4. small focal 2. obstructive 5. panacinar 3. restrictive 2. Causes of death with obstructive emphysema 1. gas acidosis and coma 2. renal failure 3. left ventricular heart failure 4. right ventricular heart failure 5. collapse of the lungs with spontaneous pneumothorax 3. The most important
    Chronic obstructive pulmonary disease is a pathological condition characterized by the formation of chronic airway obstruction due to chronic bronchitis / chronic obstructive pulmonary disease and / or pulmonary emphysema / EL /. Chronic obstructive pulmonary disease is widespread. It is estimated that HB affects about 14–20% of the male and about 3–8% of the female adult population, but only
  7. Chronic non-specific lung diseases
    Chronic non-specific lung diseases (COPD) is a group of lung diseases of various etiologies, pathogenesis and morphology, characterized by the development of chronic cough with sputum production and paroxysmal or persistent breathing difficulties that are not associated with specific infectious diseases, primarily pulmonary tuberculosis. Chronic bronchitis,
  8. Chronic diffuse inflammatory lung disease
    in accordance with the functional and morphological features, the lesions of their air-conducting or respiratory departments are divided into three groups: obstructive, restrictive, mixed - obstructive with restrictive disorders or restrictive with obstructive disorders. The combination of restriction with obstruction is observed in the late stages of almost all chronic diffuse
  9. Classification of lung diseases
    It is fundamentally important for an anesthesiologist to separate lung diseases into obstructive diseases associated with impaired air passage through the tracheobronchial tree and restrictive ones, i.e. associated with damage to the pulmonary parenchyma. Restrictive diseases Restrictive diseases of the lungs are associated with impaired compliance (extensibility) of the lung tissue and can be chronic and transient
  10. Chronic lung disease
    This group of pathological conditions is called interstitial lung disease (mechanical ventilation). They are characterized, regardless of the etiology, a gradual onset, chronic inflammation of the alveolar walls and perialveolar tissues, as well as progressive pulmonary fibrosis, which causes disturbances in gas exchange and ventilation. Inflammation may be limited to the lungs or be part of a generalized
  11. Management of patients with AF and lung disease
    Highly effective 1. First of all, it is recommended to correct hypoxemia and acidosis in patients in whom AF has developed during acute pulmonary disease, its exacerbation, or in chronic lung disease. 2. The use of diltiazem or verapamil to control the frequency of ventricular contractions in patients with bronchial obstructive pulmonary disease who have developed
  12. Occupational lung disease.
    Occupational lung diseases are indicated by the term pneumoconiosis. Pneumoconiosis (gr. Pneumon lung + konia dust) is an occupational disease caused by inhalation of dusty air. The classification of pneumoconiosis has undergone changes and includes three groups of diseases: • dust lung fibrosis from exposure to fibrogenic dust; • interstitial lung diseases from
  13. Chronic obstructive pulmonary disease
    The group of chronic obstructive pulmonary diseases includes chronic bronchitis, bronchiectasis, bronchial asthma, and pulmonary emphysema (Table 15.1). Quite certain groups are made up of individuals with predominant chronic bronchitis or emphysema (Table 15.2). Many patients develop destructive processes overlapping at the level of the bronchi (in chronic bronchitis) and acini
    In recent decades, a significant increase in the number. patients with allergic diseases of the bronchopulmonary apparatus. Allergic lung diseases include exogenous allergic alveolitis, pulmonary eosinophilia, and drug
    Ronald G. Crystal (Ronald G. Cristal) Interstitial lung disease (LLL) is a chronic, non-cancerous, non-communicable disease characterized by inflammation and disorganization of the walls of the alveoli. The most logical and serious outcome of this pathology is a decrease in the number of functioning alveolar-capillary complexes and, as a consequence, a violation of blood oxygenation.
  16. Acute lung disease
    These include pulmonary edema (including adult respiratory distress syndrome), pneumonia, and aspiration pneumonitis. General information A decrease in lung extensibility occurs due to an increase in the content of extravascular fluid in them, which in turn is due to either an increase in pressure in the pulmonary artery or an increase in the permeability of the pulmonary capillaries (Ch. 50). Increase
  17. Obstructive pulmonary disease
    Obstructive pulmonary disease is the most common group of pulmonary disorders. These include bronchial asthma, emphysema, chronic bronchitis, cystic fibrosis, bronchiectasis, and bronchiolitis. A hallmark of these diseases is increased airway resistance. In obstructive pulmonary diseases, both FEV and FEV / FVC ratio do not exceed 75% of the norm. On the
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