Developmental - Physiology of ageing

Question 1

How is airway management different in the elderly

Answer 1

1. Often edentulous
   - -> difficult BVM
   - -> easier intubation
2. Upper airway collapse
   - -> Snoring/stertor during recovery GA –> hypoxaemia

Question 2

Summarise the respiratory changes in the elderly relevant to anaesthesia

Answer 2

1. Reduced thoracic wall compliance (calcification costal cartilages)
2. Kyphosis –> affects lung mechanics
3. Atrophy respiratory muscles –> more susceptible to respiratory muscle fatigue
4. Degeneration of elastic fibres in the alveolar septae
   - -> Airway collapse during expiration –> increase CC –> V:Q mismatch
   - -> Increased lung compliance
5. Increased RV and FRC

Question 3

Describe overall respiratory compliance in the elderly

Answer 3

Increased lung compliance
Reduced thoracic cage compliance

OVerall: reduced compliance –> the gradient of the pressure - volume curve is reduced