Bronchospasm

Jai Ganesh · 2023-12-02 22:21:01

Bronchospasm

Bronchospasms happen when the muscles that line your bronchi (airways in your lungs) tighten. This results in wheezing, coughing, and other symptoms. Many things can cause bronchospasm, including asthma, and it's usually managed with bronchodilators.

Summary

Bronchospasm is a respiratory condition where the muscles that line the airways of the lungs get tightened. This results in the airways becoming narrow and this does not allow as much air to come in or leave the lungs as would happen normally. This further affects the amount of oxygen that enters our blood and the amount of carbon di-oxide that leaves our blood. As a result of low oxygen levels in their blood, a person may suffer from alveolar hypocapnia which can affect the lungs badly or cause arterial hypocapnia.

There can be a number of factors that may cause bronchospasm. These are allergens like dust and pet dander, chemical fumes, general anesthesia during surgery, exercise, chemical fumes, cold weather, exercises, smoking and smoke inhalation from fire. Some of the symptoms of bronchospasm are rapidly increasing peak inspiratory pressure, decreasing exhaled tidal volumes, slowly increasing wave on the capnograph and wheezing.

Doctors usually prescribe Beta-2 agonists that work to relax the smooth muscles of a person’s bronchi or airways to treat bronchospasm. Some of the medications that can treat bronchospasm are albuterol, terbutaline and isoetharine and metaproterenol. Doctors may also prescribe inhaled corticosteroids in the form of sprays and inhalers to prevent the narrowing of airways during asthma attacks.

Details

Bronchospasm or a bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles. It is caused by the release (degranulation) of substances from mast cells or basophils under the influence of anaphylatoxins. It causes difficulty in breathing which ranges from mild to severe.

Bronchospasms occur in asthma, chronic bronchitis and anaphylaxis. Bronchospasms are a possible side effect of some drugs: pilocarpine, beta blockers (used to treat hypertension), a paradoxical result of using LABA drugs (to treat 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. Bronchospasms are one of several conditions associated with cold housing.

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 mucus production; this reduces the amount of oxygen that is available to the individual causing breathlessness, coughing and hypoxia.

Bronchospasms are a serious potential complication of placing a breathing tube during general anesthesia. When the airways spasm or constrict in response to the irritating stimulus of the breathing tube, it is difficult to maintain the airway and the patient can become apneic. During general anesthesia, signs of bronchospasm include wheezing, high peak inspiratory pressures, increased intrinsic PEEP, decreased expiratory tidal volumes, and an upsloping capnograph (obstructive pattern). In severe cases, there may be complete inability to ventilate and loss of ETCO2 as well as hypoxia and desaturation.

Cause

Bronchospasms can occur for a number of reasons. Lower respiratory tract conditions such as asthma, chronic obstructive pulmonary disease (COPD), and emphysema can result in contraction of the airways. Other causes are side effects of topical decongestants such as oxymetazoline and phenylephrine. Both of these medications activate alpha-1 adrenergic receptors that result in smooth muscle constriction. Non-selective 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.

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.

Diagnosis

Signs and symptoms:

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

Additional Information

A bronchospasm is a contraction in the airways that can make it hard to catch your breath. Certain health conditions, such as asthma, and environmental triggers, like chemicals or cold air, can trigger it.

Bronchospasm is a tightening of the muscles that line the airways (bronchi) in your lungs. When these muscles tighten, your airways narrow. This can prevent air from entering or leaving your lungs.

Narrowed airways don’t let as much air come in or go out of your lungs. This limits the amount of oxygen that enters your blood and the amount of carbon dioxide that leaves your blood.

Bronchospasm often affects people with asthma and allergies. It contributes to asthma symptoms such as wheezing and shortness of breath.

Symptoms of bronchospasm

When you have bronchospasm, your chest feels tight, and it can be hard to catch your breath. Other symptoms include:

* wheezing (a whistling sound when you breathe)
* chest pain or tightness
* coughing
* fatigue
* dizziness

Causes of bronchospasm

Any swelling or irritation in your airways can cause bronchospasm. This condition commonly affects people with asthma.

Other factors that can contribute to bronchospasm include:

* chronic obstructive pulmonary disease (COPD), a group of lung conditions that includes chronic bronchitis and emphysema
* allergens, such as dust and pet dander
* chemical fumes
* general anesthesia during surgery
* infection of the lungs or airways
* exercise
* cold weather
* smoke inhalation from a fire
* smoking, including tobacco and illegal drugs

Diagnosing bronchospasm

To diagnose bronchospasm, you can see your primary care doctor or a pulmonologist (a doctor who treats lung diseases). The doctor will ask about your symptoms and find out if you have any history of asthma or allergies. Then, they’ll listen to your lungs as you breathe in and out.

You may have lung function tests to measure how well your lungs work. These tests may include the following:

* Spirometry. In this test, you breathe into a tube that’s connected to a device called a spirometer. The spirometer measures the force of the air as you breathe in and out.
* Lung volume test. This test measures how much oxygen your lungs can hold.
* Lung diffusion capacity. In this test, you breathe in and out through a tube to see how well oxygen gets into your blood. Your doctor might also test your level of hemoglobin — a protein that helps transport oxygen in your blood.
* Pulse oximetry. A device is clipped onto your finger to measure the oxygen level in your blood.
* Eucapnic voluntary hyperventilation. This test is used to diagnose exercise-induced bronchospasm. You breathe in a mixture of oxygen and carbon dioxide to simulate breathing during exercise. Your doctor will see if breathing in this mixture affects your lung function.

You might also have one of these tests:

* Chest X-ray. Your doctor will use a chest X-ray to look for pneumonia or other signs of infection.
* CT scan. This test uses X-rays to look for problems in your lungs.

Treating bronchospasm

Your doctor may treat your bronchospasm with medications that widen your airways and help you breathe easier. These medications may include:

* Short-acting bronchodilators. These medications are used for quick relief of bronchospasm symptoms. They start working to widen the airways within a few minutes, and their effects last for up to 4 hours.
* Long-acting bronchodilators. These medications keep your airways open for up to 12 hours but take longer to start working.
* Inhaled steroids. These drugs lower swelling in your airways. You can use them for long-term management of bronchospasm. They also take longer to start working than short-acting bronchodilators.
* Oral or intravenous (IV) steroids. These may be required if your bronchospasm is severe.

If you get exercise-induced bronchospasm, take your short-acting medication about 15 minutes before you work out.

You might need to take antibiotics if you have a bacterial infection.

Preventing bronchospasm

Here are a few things you can do to help prevent bronchospasm:

* Warm up for 5–10 minutes before you exercise, and cool down for 5–10 minutes afterward.
* If you have allergies, don’t exercise when the pollen count is high.
* Drink lots of water throughout the day to loosen up any mucus in your chest.
* Exercise indoors on very cold days. Or wear a scarf over your nose and mouth when you go outside.
* If you smoke, ask your doctor for advice to help you quit. Try to avoid staying near people who smoke.
* If you’re age 65 or older, or if you have a chronic lung condition or immune system problem, try to stay up to date on your pneumococcal and influenza vaccines.

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#1 2023-12-02 22:21:01

Bronchospasm

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