The assessment of major airway function in a ventilator-dependent patient with tracheomalacia.

Abstract:

:A 60-pack-year smoker presented with cough, dyspnea and orthopnea of three months' duration. Spirometry revealed severe reduction in maximal expiratory flow; CT of the chest and bronchoscopy demonstrated expiratory collapse of a mid-tracheal segment, and a presumptive diagnosis of tracheomalacia was made. A right lateral thoracotomy was performed to resect the unstable segment and improve maximal expiratory flow. Diffuse major airway disease with absence of cartilaginous rings from the thoracic inlet to the mainstem bronchi was encountered. The trachea and mainstem bronchi were stented externally. A high resistance to airflow and absence of expiratory flow limitation were present, suggesting a fixed rather than variable intrathoracic obstruction of major airways. This case illustrates some potential pitfalls in preoperative assessment of patients with tracheomalacia. Recordings of airway pressure and flow during mechanical ventilation are useful in distinguishing between fixed and variable intrathoracic obstruction and may complement tests of airway anatomy.

journal_name

Chest

journal_title

Chest

authors

Dunn WF,Hubmayr RD,Pairolero PC,Sheedy PF,Edell ES,Nelson SB

doi

10.1378/chest.97.4.939

subject

Has Abstract

pub_date

1990-04-01 00:00:00

pages

939-42

issue

4

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)35067-X

journal_volume

97

pub_type

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