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The Airway and Lungs

  • Martin W. Dünser
  • Daniel Dankl
  • Sirak Petros
  • Mervyn Mer
Chapter

Abstract

Extremely useful and relevant information can be obtained when analysing the position assumed by patients with dyspnoea. Relief of breathlessness in a sitting or standing position compared to the recumbent position is referred to as orthopnoea. While increased venous return in the supine patient is well tolerated in individuals with a preserved heart function, this leads to pulmonary venous congestion, an increase in interstitial lung water and a subsequent reduction of lung capacities with resultant shortness of breath in patients with impaired heart function. Accordingly, patients with heart failure prefer to sit upright (e.g. supporting their back with pillows to achieve a maximum upright position) (Fig. 5.1). Conversely, placing the patient into a supine position may be used as a stress test to exclude respiratory distress due to heart failure or (pulmonary) fluid overload. A history of paroxysmal nocturnal dyspnoea characterized by repeated awakening due to breathlessness while sleeping in the recumbent position is a typical symptom of heart failure.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Martin W. Dünser
    • 1
  • Daniel Dankl
    • 2
  • Sirak Petros
    • 3
  • Mervyn Mer
    • 4
  1. 1.Department of Anesthesiology and Intensive Care MedicineKepler University Hospital, Johannes Kepler University LinzLinzAustria
  2. 2.Department of Anesthesiology, Perioperative Medicine and General Intensive CareSalzburg University Hospital and Paracelsus Private Medical UniversitySalzburgAustria
  3. 3.Medical Intensive Care Unit and Centre of Haemostaseology, University Hospital LeipzigLeipzigGermany
  4. 4.Divisions of Critical Care and Pulmonology, Department of MedicineCharlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences University of the WitwatersrandJohannesburgSouth Africa

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