Complications/ risks of surgery in Asthma patient?

Patients who have asthma are at risk for specific complications during and after surgery. These
complications include:

• Acute bronchoconstriction triggered by intubation,
• Hypoxemia and
• Possible hypercapnia,
• Impaired effectiveness of cough,
• Atelectasis, and
• Respiratory infection
• Latex exposure (allergy)
• Allergy to some anesthetic agents

The likelihood of these complications depends on the severity of the patient’s airway
hyperresponsiveness, airflow obstruction, mucus hypersecretions, latex sensitivity, and
history of prior surgeries, because the latter is a risk factor for both latex and anesthetic
agent sensitivities.
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Actions to be taken before surgery in asthma patients:

Patients who have asthma should have an evaluation before surgery that includes a review of symptoms, medication use (particularly the use of oral systemic corticosteroids for longer than 2 weeks in the past 6 months), and measurement of pulmonary function.

If possible, attempts should be made to improve lung function preoperatively (FEV1 or peak expiratory flow rate [PEFR]) to either their predicted values or their personal best level. A short course of oral systemic corticosteroids may be necessary to optimize lung function.

For patients who have received oral systemic corticosteroids during the past 6 months and for selected patients on a long-term high dose of an ICS, give 100 mg hydrocortisone every 8 hours intravenously during the surgical period and reduce the dose rapidly within 24 hours after surgery. Stress doses of
corticosteroids may be considered for select patients treated with prior high-dose ICS therapy as well, because clinically important adrenal suppression has been reported in such patients, particularly children.
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Gastro-esophageal Reflux syndrome and asthma:

Asthma may be caused or worsened by to gastro-esophageal reflux. The symptoms of GERD are common in both children and adults who have asthma. Reflux during sleep can contribute to nocturnal asthma. Treatment with a proton pump inhibitor was reported to reduce nocturnal symptoms, reduce asthma exacerbations, and improve quality of life related to asthma. Surgical treatment has been reported to reduce the symptoms of asthma and the requirement for medication.
For patients who have poorly controlled asthma, particularly with a nocturnal component, investigation for GERD may be warranted even in the absence of suggestive symptoms
medical management of GERD be instituted for patients who have asthma and complain of frequent heartburn or pyrosis, particularly those who have frequent episodes of nocturnal asthma.

Medical management of GERD includes:

• Avoiding heavy meals, fried food, caffeine, and alcohol.
• Avoiding food and drink within 3 hours of retiring.
• Elevating the head of the bed on 6- to 8-inch blocks.
• Using appropriate pharmacologic therapy.

For patients who have persistent reflux symptoms following optimal therapy, further evaluation
is indicated and surgical treatment may be advised.
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Sugar Intake Linked to Asthma in kids

Diet Rich in Sweets Could Promote Kids' Asthma, Study Shows
Sugar could give kids asthma, animal research suggests. Asthma now affects nearly 9% of children and teens, a figure that has doubled since the 1980s, according to a study published last year.

To test their theory, the researchers studied two groups of mice. One group was given water. The other mice were offered sugar-laced water and allowed to drink up -- as much as they wanted.

"Their behavior was just like in kids," Kierstein tells WebMD. "Once they tasted [the sugar water], they went back again and again."

Both groups of mice were then injected with an allergen in an effort to make them more tolerant to that allergen. The idea of tolerance is to strengthen the immune system to fight off the effects of a future exposure to that allergen. Allergens are substances that can cause allergic reactions such as runny noses and hives and can trigger asthma symptoms.

Then, both groups of mice were reinjected with the same allergen and the researchers looked at whether there was any difference in how susceptible the two groups were to inflammation in the airways and the allergic response.

Kierstein says, "is that the sugar-fed mice had more than twice as much airway inflammation as the water-fed mice. Their immune systems were more activated. This makes them more susceptible to asthma."

High-fructose corn syrup, soda and sugar-laden fruit punch, an ingredient in many fruit drinks, are also rich in sugar or other form of sugar."

Asthma