Chief of Thoracic Anaesthesiology, Department of Anesthesiology, Resuscitation and Intensive care, University Hospital Ostrava, Czech Republic
Chronic lung diseases have an increasing frequency and severity worldwide. Therefore, we will encounter them more often during our clinical practice. Although these are primarily lung diseases, they have significant extrapulmonary effects and these must also be kept in mind during the care of patients with lung disease. Based on the dominant lung involvement, chronic lung disease can be divided into obstructive and restrictive, or mixed. To put it simply, the obstructive type of disorder is a reduced patency of the bronchial tree and a restrictive disorder is a reduction in the area of the lungs where the gas exchange takes place, with a concomitant decrease in lung compliance. For this reason, the anesthesiological approach in the perioperative period in patients with some type of lung disease is also different. In this algorithm, COPD ( Chronic obstructive pulmonary disease ) was selected for the group of obstructive diseases and IPF( Idiopathic pulmonary fibrosis ) was selected for the group of restrictive diseases. In both branches of the algorithm, the most significant differences are emphasized both in the preoperative preparation and in the management of anesthesia itself (pharmacotherapy, lung ventilation ).