Causes include airway secretions, foreign body, pulmonary edema (cardiac asthma), obstructed endotracheal tube, endotracheal tube at the carina or down a main-stem bronchus, allergic or anaphylactic response to drugs, and asthma. A number of medications cause wheezing in asthmatic patients, including p-blockers, muscle relaxants, and aspirin.
After carefully checking the endotracheal tube and listening for bilateral breath sounds, increase the inspired oxygen to 100% and deepen the anesthetic if hemodynamically tolerated by the patient. Provoking factors such as medication infusions, misplaced endotracheal tubes, or other causes of airway stimulation should be corrected. Manipulating the ventilator (see question 14) may help. Administer medications as suggested in Question 7.
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