Central airway mechanics and flow limitation in acquired tracheobronchomalacia.
作者： Stephen H. Loring , Carl R. O'Donnell , David J. Feller-Kopman , Armin Ernst
关键词: Tracheomalacia 、 COPD 、 Tracheobronchomalacia 、 Tracheobronchoplasty 、 Exhalation 、 Cardiology 、 Medicine 、 Surgery 、 Collapse (medical) 、 Internal medicine 、 Bronchoscopy 、 Transpulmonary pressure
摘要: Background Acquired tracheobronchomalacia (TBM) can cause central airway collapse in patients with COPD and may worsen airflow obstruction symptoms. It is usually not known whether malacia contributes to obstruction. This study was undertaken quantify collapsibility relate it expiratory flow limitation TBM. Methods Eighty evaluated for acquired TBM 4 healthy control subjects were studied measurements of narrowing derived from bronchoscopic videotapes simultaneous pressure the trachea esophagus. Tracheal assessed by a shape index plotted against transtracheal measure collapsibility. Subsequently, transpulmonary (PL) measured identify during quiet breathing determine critical PL required maximum flow. Results varied widely among patients. Some had profound tracheal breathing, others showed substantial only forced exhalation. Of patients, 15% limited 53% throughout exhalation, 30% latter part Patients at rest greater than those without (p = 0.009), but severity closely related Twenty-three exhalation PLs that did collapse. Conclusions In TBM, obstruction, often occurs peripheral airways
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