COPD Flashcards
What are the COPD GOLD categories?
1 (mild) FEV1 >=80%, 2 (mod) >=50-80, 3 (severe) >=30-50, 4 (very severe) <30
What’s an example of abnormal DLCO but normal A-a gradient?
Chest wall disease where the DLCO needs to be corrected for ventilation
What’s a ball-valve effect?
A partial airway obstruction that allows inflow during inspiration but obstruct outflow during expiration, leading to gas trapping distal to the obstruction & potentially compression of surrounding structures- most significant complication= PTx which if untreated could–> cardioresp collapse.
What is it about CF that risks cor pulmonate?
severe obstructive lung disease & chronic hypoxaemiz
What are the concerns with OSA as a day case?
- Postop apnoea & cardiac arrest, 2. exactly R) heart failure, 3. Surg/anaesthetic factors impeding safe discharge
What are some causes of OSA?
Obesity, CNS (stroke), post airway surgery, chest wall, myaesthenia/other bulbar muscle dysfunction, congenital
What’s the breakdown of AHI scores?
<5 normal (no OSA), 5-<15 mild, 15-<30 moderate, >=30 severe
What does the RDI in sleep studies correlate with?
Respiratory disturbance index, correlates w neurocognitive decline from OSA
What’s the most important consideration for OSA?
What’s the cause? eg. CNS vs obesity
What does ODI >5 mean?
Oxygen desaturation index- number of times SpO2 drop >=4% from baseline per hr (ie. >5x/hr for ODI of >5)
What does high bicarb in OSA tell us?
Chronic CO2 retainer, may increase threshold for an art line to take gases intra-op & see what CO2 doing
What’s an apnoea in polysomnography?
Drop of at least 90% of airflow from baseline lasting 10 s or longer
What’s a hypopnoea in polysomnography?
Drop of at least 30% of airflow from baseline lasting 10 s or longer, ass’d w either 3% O2 desat or arousal
