Perioperative management of COPD patients emphasizes avoiding tracheal intubation, using regional anesthesia, and utilizing noninvasive ventilation to prevent and treat pulmonary complications.
May support regional anesthesia and NIV to reduce COPD complications; leaves open need for RCTs before practice change.
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is a common cause of primary hospital admission and also a common coexisting disease among surgical patients. This translational review focused on recent studies related to the perioperative care of COPD patients. RECENT FINDINGS: In addition to the crucial role of smoking cessation, the use of corticosteroids, antibiotics, regional anesthesia techniques and noninvasive ventilation has become a focus in the perioperative management of the COPD patient. SUMMARY: Perioperative management as well as modern intensive care concepts are based on avoidance of tracheal intubation if possible, use of regional anesthesia techniques and the early liberation from invasive mechanical ventilation. Noninvasive ventilation has become more and more utilized in recent years to stabilize patients with acute exacerbations of COPD and to treat postoperative pulmonary complications in order to avoid reintubation.
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Spieth et al. (2012) studied this question.
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