Compromised cardiopulmonary function

Irritants and allergens activate sensory nerves directly or by the release of mediators from inflammatory cells. Although mast cells and basophils appear to have some capacity to release mediators on exposure to irritants, direct evidence of the physiological responses from irritant-induced mediator release is sparse. It is a very attractive hypothesis that this type of nonimmune activation of inflammatory cells releases mediators of the anaphylactic responses to constitute an amplification mechanism contributing to the increase in morbidity and mortality in persons with compromised cardiopulmonary function or hyperresponsiveness to irritants and allergens. 

Exposures to ambient particulate matter (PM), especially fine PM with an aerodynamic radius of 2.5 pm (PM2.5), have been consistently related to increases in mortality and morbidity (Dockery et al. 1993 Burnett et al. 1999). The effects of ambient PM exposures on certain vulnerable populations such as the elderly, those with compromised cardiopulmonary health and children are of particular concern. A number of studies have demonstrated, for instance, that exposure to air pollution is associated with reductions in lung function and growth, asthma, allergic rhinitis and respiratory infections in children (Janssen et al. 2003 Brauer et al. 2007). Among other things, their susceptibility can be attributed to the immaturity of their respiratory defence mechanisms and higher permeability of their airways to air pollutants compared to adults. 

Finally, newer intravenous anesthetics such as etomidate (Amidate) and propofol (Diprivan) are available. Etomidate is a hypnoticlike drug that causes a rapid onset of general anesthesia with a minimum of cardiopulmonary side effects. Flence, this drug may be useful in patients with compromised cardiovascular or respiratory function. Propofol is a short-acting hypnotic that is useful as a general anesthetic in some... 

---