Bilevel positive airway pressure in tracheobronchomalacia

A subsequent dynamic non-contrast CT scan of thorax showed expiratory collapse of tracheal and bilateral bronchial lumen, demonstrating tracheobronchomalacia (TBM) and reasonable airway patency achieved with application of BPAP (figure 2). TBM is often confirmed by dynamic chest CT imaging or bronch...

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Bibliographic Details
Published in:BMJ case reports 2021-10, Vol.14 (10), p.e246331
Main Authors: Pradeep, Nambron Prathyush, Ayub, Irfan Ismail, Krishnaswamy, Madhavan, Periakaruppan, Gokulakrishnan
Format: Article
Language:English
Subjects:
Case reports
Continuous Positive Airway Pressure
Dyspnea
Hospitals
Humans
Hypertension
Images In
Medical imaging
Ostomy
Patient admissions
Pneumonia
Polysomnography
Respiration
Sleep apnea
Sleep Apnea, Obstructive
Spirometry
Tracheobronchomalacia - diagnostic imaging
Tracheobronchomalacia - therapy
Ventilators
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Summary:A subsequent dynamic non-contrast CT scan of thorax showed expiratory collapse of tracheal and bilateral bronchial lumen, demonstrating tracheobronchomalacia (TBM) and reasonable airway patency achieved with application of BPAP (figure 2). TBM is often confirmed by dynamic chest CT imaging or bronchoscopic examination of the airways during respiration.1 Treatment is directed towards keeping the airway patent, achieved by either CPAP, airway stenting or surgical measures such as tracheobronchoplasty or tracheostomy.1 2 Among them, CPAP or BPAP, being a non-invasive intervention, appears to be the preferred approach, especially in elderly patients with multiple comorbidities, and ensures positive airway pressure both during inspiration and expiration.2 The latter is essential, as airway collapse in TBM is primarily expiratory. Patient’s perspective I was having recurrent hospital admissions for respiratory symptoms over the last 6 years, often requiring intensive care unit (ICU) admission and high pressure mask (NIV).
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-246331