ABSTRACT
The surgeon may be required to participate in the critical care management of the patient
with bronchospasm during postoperative bronchospasm exacerbations and following
trauma. Bronchospasm is defined as reversible obstructive airway disease. The hallmark
of obstructive airway disease is airflow limitation with an impediment to expiration.
Asthma is the prototype of bronchospasm, and this chapter is mainly devoted to the man-
agement of status asthmaticus. However, chronic obstructive pulmonary disease (COPD)
patients also may have some component of reversible obstruction. The pharmacologic
therapy of bronchospasm is similar for asthma and COPD. Although reversibility is antici-
pated in asthma, the degree of reversibility in COPD may vary from significant response to
bronchodilator therapy to no response at all. Independent of the etiology (asthma or
COPD), bronchospasm predisposes a patient to postoperative or post-traumatic pulmonary
complications through an increased risk of atelectasis and the direct physiologic
consequences of bronchospasm itself.
