Bronchospasm

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Bronchospasm
Inflamed airways and bronchoconstriction in asthma. Airways narrowed as a result of the inflammatory response cause wheezing.
SpecialtyPulmonology

Bronchospasm or a bronchial spasm is a sudden

mast cells or basophils under the influence of anaphylatoxins
. It causes difficulty in breathing which ranges from mild to severe.

Bronchospasms occur in

COPD), and other drugs. Bronchospasms can present as a sign of giardiasis
.

Some factors that contribute to bronchospasm include consuming certain foods, taking certain medicines, allergic responses to insects, and fluctuating hormone levels, particularly in women.[1][2] Bronchospasms are one of several conditions associated with cold housing.[3]

The overactivity of the bronchioles' muscle is a result of exposure to a stimulus which under normal circumstances would cause little or no response. The resulting constriction and inflammation causes a narrowing of the airways and an increase in

hypoxia
.

Bronchospasms are a serious potential complication of placing a

ETCO2
as well as hypoxia and desaturation.

Cause

Bronchospasms can occur for a number of reasons. Lower respiratory tract conditions such as

beta blockers are known to facilitate bronchospasm as well. Beta blockers bind to the β2 receptors and block the action of epinephrine and norepinephrine causing shortness of breath.[4]

Additionally, the pediatric population is more susceptible to disease and complications from bronchospasm due to their airway diameter being smaller; applying

Poiseuille's Law to the airways it is clear that airflow resistance through a tube is inversely related to the radius of the tube to the fourth power, therefore, decreases in airway results in significant flow impediments.[5]

Diagnosis

Signs and symptoms:

  • Wheezing
  • Diminished breath sounds
  • Prolonged expiration
  • Increase airway pressures (in ventilated patients)

Treatment

Beta 2 agonists

Beta2-adrenergic agonists are recommended for bronchospasm.

  • Short acting (SABA)
  • Long acting (
    LABA
    )
  • Others
    • Epinephrine
      - titrate to effect (e.g. 10-50 mcg IV), especially in setting of hemodynamic compromise
    • increasing anesthetic depth
    • IV magnesium
    • Increase FiO2 to 100% and consider manual ventilation

Muscarinic Acetylcholine receptor antagonist

See also: Parasympathetic nervous system and Sympathetic nervous system

The

smooth muscle tissue. Ongoing research and successful clinical trials have shown that agents such as diphenhydramine, atropine and Ipratropium bromide (all of which act as receptor antagonists of muscarinic acetylcholine receptors) are effective for treating asthma and COPD-related symptoms.[6]

See also

References

  1. PMID 12669890
    .
  2. ^ Hatfield. "Asthma in Women".
  3. S2CID 154051241
    .
  4. ISSN 1755-0017
    .
  5. PMID 31536291
    . Retrieved November 22, 2020.
  6. PMID 21198547
    .

External links

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