Source: Annual Congress 2007 - Mechanical ventilation and airways
Disease area: Airway diseases, Respiratory critical care

Abstract

Aim: Tracheobronchomalasia (TBM) and excessive dynamic airway collaps should be considered in COPD patients who required frequent ventilatory support, who had hypersecretion with insufficient expectoration, and weaning difficulty. We aimed to point of such patients, and present airway stenting results.
Methods: Four male COPD patients aged 58-75 years admitted to respiratory intensive care unit (ICU) due to acute respiratory failure (ARF) who subsequently diagnosed TBM were evaluated. Fiberoptic bronchoscopy (FOB) images were recorded in video forms. In all patients, stenting was performed by using rigid bronchoscopy in the operating room, and Dumon ?y‘ type silicone stents were used.
Results: Duration of COPD was ranged 6-20 y. The number of hospitalizations per year was over 2 in all, and 2 of them had recurrent ICU admissions. Saber sheath type trachea was found in 2 patients, TBM in 1, and excessive dynamic airway collaps was found in 1. Stenting indications were as follows: weaning failure in 2 patients, hypersecretion and insufficient expectoration in the remaining 2. Patients were followed up 3-18 months after stenting. In 1 patient, stenting was required two times and that patient underwent surgical tracheostomy. In 1 patient, stenting was performed simultaneously with right upper lobectomy, and the stent was removed 2 months later in that patient. FOB was done 3-10 times for revision in all patients. Complications were hypersecretion, cough, and minor chest pain. No more ARF required ICU admission was seen.Conclusions: In COPD patients with TBM or excessive dynamic airway collaps, airway stenting should be considered as a method of enhanced life-quality.

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Citations should be made in the following way:
R. Baran, T. Yarkin, G. Gungor, Z. Karakurt, N. Adiguzel, O. Sogukpinar, A. Kir (Istanbul, Turkey). Tracheobronchomalasia, excessive dynamic airway collaps, and airway stenting in COPD patients. Eur Respir J 2007; 30: Suppl. 51, 1943

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