Content Search Test - MJ-Care of the Critically Ill Patient with Obstructive Lung Disease_Hibbert_2023

Care of the Critically Ill Patient with Obstructive Lung Disease_Hibbert_2023 - 1

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This document is a review of the care of critically ill patients with obstructive lung disease. It covers topics such as the physiology of respiratory failure, pharmacologic therapy, ventilatory support, and adjuvant therapies. <br /><br />The physiology of obstructive respiratory failure is explained, highlighting increased airway resistance and work of breathing due to factors such as airway inflammation and hyperinflation. Dynamic hyperinflation and flow limitation in severe obstructive disease are also discussed.<br /><br />Pharmacologic therapy for asthma and chronic obstructive pulmonary disease (COPD) is reviewed. Inhaled beta-adrenergic agonists, inhaled anticholinergics, and corticosteroids are commonly used treatments. Antibiotics may be indicated for severe COPD exacerbations, while magnesium sulfate may be used for life-threatening asthma exacerbations.<br /><br />Ventilatory support options include supplemental oxygen, non-invasive ventilation, and invasive mechanical ventilation. The goals of management include decreasing airway resistance, managing hyperinflation, and optimizing gas exchange.<br /><br />The document emphasizes the importance of minimizing autoPEEP and work of breathing in patients with obstructive lung disease. Strategies to optimize expiratory time, such as adjusting respiratory rate and using extrinsic positive end-expiratory pressure (PEEP), are discussed.<br /><br />Additional adjuvant therapies mentioned include smoking cessation counseling, deep vein thrombosis prophylaxis, nutrition support, and physical therapy. Palliative care is also highlighted as an underutilized resource for COPD patients.<br /><br />In conclusion, this document provides a comprehensive overview of the care of critically ill patients with obstructive lung disease. It covers the physiology of respiratory failure, pharmacologic therapy, ventilatory support, and adjuvant therapies, emphasizing the importance of minimizing autoPEEP, managing hyperinflation, and optimizing gas exchange.

Keywords

care of critically ill patients

obstructive lung disease

physiology of respiratory failure

pharmacologic therapy

ventilatory support

adjuvant therapies

airway resistance

work of breathing

dynamic hyperinflation

flow limitation