Could you please explain the mechanism of action of CPAP on bronchoconstriction? I recently had a patient who stated they had both COPD and asthma. They were taking fluticasone and salbutamol and she met the conditions for CPAP, however, she had audible wheezing. Upon auscultation, it seemed that wheezing was coming from the upper airways. While this seemed it was a COPD exacerbation, we had concerns on how the CPAP would effect the obvious bronchoconstriction. Ultimately, we gave this patient salbutamol and dex, and they significantly improved by the time we arrived at the ED. However, I would like to know where the line is when it comes to these patients with respiratory comorbidities? And what cautions should we have with CPAP?
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