Review article

Age related alterations in respiratory function - Anesthetic considerations

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Purpose: This review examines the effect of aging on pulmonary reserve. Special emphasis is placed on how anesthetic and surgical factors may impose substantial stresses on the respiratory system of elderly patients, leading to increased risk for postoperative pulmonary complications including respiratory failure. Source: A MEDLINE-based English-language literature search was undertaken for the period 1966-2006, and an EMBASE search covered the overlapping period 1988-2006. Selected articles were limited to those applying to elderly subjects/patients. Principal findings: Age-related loss of the lung static recoil forces, stiffening of the chest wall and diminished alveolar surface area lead to a decrease in vital capacity, an increase in residual volume, decrease in expiratory flows and increased venti lation-perfus ion heterogeneity. Respiratory muscle strength consistently declines with age further increasing the work of breathing. While gas exchange may be well preserved at rest and during exertion, pulmonary reserve is diminished, and under conditions of positive fluid balance, positioning for surgery, and increased metabolic demand, postoperative respiratory failure can occur. Increased sensitivity to respiratory depressants and muscle weakness pose additional risks for the development of postoperative respiratory complications in elderly patients. Regional anesthetic techniques provide for superior postoperative analgesia, without necessarily altering the frequency of postoperative pulmonary complications in the older surgical population. Conclusion: Alterations in respiratory physiology associated with aging must be appreciated to anticipate and minimize potential complications associated with surgery and anesthesia in the elderly. Individualized care to optimize preoperative cardiorespiratory function, minimize intraoperative respiratory pertubations, and to gently restore postoperative pulmonary function are essential anesthetic goals for elderly patients who require surgery.

Original languageEnglish (US)
Pages (from-to)1244-1257
Number of pages14
JournalCanadian Journal of Anesthesia
Volume53
Issue number12
StatePublished - Dec 2006

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Anesthetics
Lung
Respiratory Muscles
Respiratory Insufficiency
Respiratory Physiological Phenomena
Work of Breathing
Residual Volume
Water-Electrolyte Balance
Bariatric Surgery
Muscle Weakness
Vital Capacity
Muscle Strength
Thoracic Wall
MEDLINE
Respiratory System
Analgesia
Language
Anesthesia
Gases
Ions

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Review article : Age related alterations in respiratory function - Anesthetic considerations. / Sprung, Juraj; Gajic, Ognjen; Warner, David Oman.

In: Canadian Journal of Anesthesia, Vol. 53, No. 12, 12.2006, p. 1244-1257.

Research output: Contribution to journalArticle

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