Download Anesthesia and the Lung 1992 by J. B. West (auth.), T. H. Stanley, R. J. Sperry (eds.) PDF

By J. B. West (auth.), T. H. Stanley, R. J. Sperry (eds.)

Anesthesia and the Lung 1992 provides contemporary advances within the analysis, pre-, intra-, and postoperative anesthetic administration of sufferers with lung disorder, providing for pulmonary and non-pulmonary surgical procedure. It additionally bargains with ventilation-perfusion concerns, the lung as a metabolic organ, the consequences of anesthesia on pulmonary mechanics and pulmonary blood circulation. additionally, there are chapters that target hypoxia; nearby adjustments within the lung; pulmonary surfactant; contemporary advances within the knowing of pulmonary edema; excessive altitude sickness; anesthesia and the keep an eye on of respiring; fresh improvement in oximetry; instrumentation designed to degree pulmonary oxygen rigidity, pO2 and pCO2 transcutaneously; differential lung air flow; reactive airlines; septic surprise; the grownup respiration misery syndrome and various facets of ventilatory help.

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10. Decreased airway humidity Endotracheal intubation Aspirated gastric acid Cigarette smoke Air pollutants Hyperoxia Viral respiratory tract infections Abdominal and thoracic incisions Inhalational anesthetics Other drugs: local anesthetics, narcotics, etc. B. Phagocytic Mechanisms The alveolar macrophage is the phagocyte that is most important in ingesting particles, including bacteria, that reach the alveolar surface. After phagocytosis, the macrophages are transported up the trachea (via the mucociliary apparatus) and out of the lung, or they may move into the interstitium to the lymphatics.

One way for lung damage to occur is for the normal lung defense mechanisms that handle the toxic materials in the inhaled gas to fail, allowing the toxic agents to reach or remain in the lower respiratory tract (see chapter, "Mechanisms of Lung Injury-An Overview"). The defense mechanisms of the lung fall into 3 general categories, including mechanical, phagocytic, and humoral factors. A. Mechanical Factors Laryngeal and epiglottic reflexes are important in keeping solids and large volumes of toxic liquids and gases from reaching the tracheobronchial tree.

In addition, removal of the particles requires a functional mucociliary apparatus. The specialized airway secretory epithelial cells produce a complex mucus lining material in the conducting airways that includes sol and gel layers. This liquid sheet is propelled upward to the pharynx by the coordinated beating of cilia of the ciliated epithelial cells. The process is under complex neural and humoral control. Cystic fibrosis is a disease resulting from a heritable defect in the regulation of water and solute content of airway fluid.

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