Preparing the Patient With COPD for Surgery

Abstract

Obstructive lung disease is not really a disease but a physiologic impairment which occurs as a result of varying combinations of diseases such as chronic bronchitis, obstructive emphysema, asthma, bronchiectasis, mucoviscidosis (cystic fibrosis), and central airway obstruction. Chronic bronchitis is defined clinically as sputum production on most days of the week for at least three months of the year in two or more consecutive years. Pathologically, it is defined in terms of mucous and serous gland and goblet cell hyperplasia in the bronchial walls. In the strictest sense, emphysema is defined as “a condition of the lung characterized by increase beyond the normal in the size of air spaces distal to the terminal bronchioles, with destructive changes in their walls. However, the term is often used more loosely in referring to chronic cigarette smokers who develop hyperinflation of the lungs by physical examination and chest roentgenogram and/or airflow obstruction and loss of elastic recoil of the lung detected in the pulmonary function laboratory.