Preoperative management of chronic bronchitis

Patients with chronic bronchitis for whom major elective surgery is indicated are at increased risk for perioperative respiratory complications. The principal clinical features of chronic bronchitis, including excessive mucus secretion, productive cough, and respiratory infection, are related to a persistent inflammatory insult. The insult provokes mucus hypersecretion, obstruction to airflow, and paralysis of airway defense mechanisms. A comprehensive preoperative medical regimen that reduces inflammation, clears and reduces mucus secretions, treats underlying infection, ameliorates inflammation, and increases airway caliber ensures the best surgical outcome.