Extrapulmonary Respiratory Diseases

  • Joshua O. BendittEmail author


Restrictive lung diseases (RLDs) are disease processes which limit expansion of the respiratory system resulting in a reduction in lung volumes when measured by pulmonary function tests (PFTs). Extrapulmonary lung diseases cause respiratory muscle weakness, significant skeletal deformity or scarring of the pleural space can result in reduced lung volumes due an inability to expand the chest wall and therefore the lungs. These physiologic abnormalities can lead to increased perioperative risks but these can be mitigated with a careful preoperative evaluation and the use of noninvasive ventilation support and cough support with mechanical insufflation–exsufflation (MI-E or CoughAssist™) postoperatively.


Extrapulmonary lung disease Restrictive lung disease Perioperative care 


  1. 1.
    Scarlata S, Costanzo L, Giua R, Pedone C, Incalzi RA. Diagnosis and prognostic value of restrictive ventilatory disorders in the elderly: a systematic review of the literature. Exp Gerontol. 2012;47(4):281–9. Scholar
  2. 2.
    Benditt JO, Boitano LJ. Pulmonary issues in patients with chronic neuromuscular disease. Am J Respir Crit Care Med. 2013;187(10):1046–55. Scholar
  3. 3.
    Bach JR, Sinquee DM, Saporito LR, Botticello AL. Efficacy of mechanical insufflation-exsufflation in extubating unweanable subjects with restrictive pulmonary disorders. Respir Care. 2015;60(4):477–83. Scholar
  4. 4.
    Birnkrant DJ, Panitch HB, Benditt JO, Boitano LJ, Carter ER, Cwik VA, Finder JD, Iannaccone ST, Jacobson LE, Kohn GL, Motoyama EK, Moxley RT, Schroth MK, Sharma GD, Sussman MD. American College of Chest Physicians consensus statement on the respiratory and related management of patients with Duchenne muscular dystrophy undergoing anesthesia or sedation. Chest. 2007;132(6):1977–86. Scholar
  5. 5.
    Dronkers JJ, Chorus AMJ, van Meeteren NLU, Hopman-Rock M. The association of preoperative physical fitness and physical activity with outcome after scheduled major abdominal surgery. Anaesthesia. 2013;68(1):67–73. Scholar
  6. 6.
    Blichfeldt-Lauridsen L, Hansen BD. Anesthesia and myasthenia gravis. Acta Anaesthesiol Scand. 2012;56:17–22. Scholar
  7. 7.
    Dhallu MS, Baiomi A, Biyyam M, Chilimuri S. Perioperative management of neurological conditions. Health Serv Insights. 2017;10:1–8. Scholar
  8. 8.
    Qaseem A, Snow V, Fitterman N, et al. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing noncardiothoracic surgery: a guideline from the American College of Physicians. Ann Intern Med. 2006;144(8):575–80. image in new window

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Medicine, Division of Pulmonary, Critical Care & Sleep MedicineUniversity of Washington School of MedicineSeattleUSA

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