Severe Tracheomalacia in the ICU: Identification of Diagnostic Criteria and Risk Factor Analysis From a Case Control Study

Kandaswamy, Chitra; Bird, Garrett; Gill, Narinder; Math, Edward; Vempilly, Jose Joseph

doi:10.4187/respcare.01866

Cited by 27 publications

(32 citation statements)

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“…Severe tracheomalacia and tracheobronchomalacia are increasingly recognized as a cause for respiratory failure in the intensive care unit and prolonged hospital stay; however, the diagnosis is often overlooked, as chest radiography appears normal, and the role of invasive diagnostic testing for this diagnosis is not well illustrated [6]. Down syndrome is seen in the literature to be linked to narrowing of the trachea especially in newborns but is rarely diagnosed in adults.…”

Section: Discussionmentioning

confidence: 99%

“…Intratracheal stents are divided into two major types consisting of silicone stents and shape-memory alloy stents. Silicone stents are easily implanted and removed but are associated with several complications including infection, expectoration, and tendency to undergo migration, and restenosis [6]. Tracheal stent placement may be useful in improving ventilator dependence; however, as there is a risk with stent placement due to excessive laxity of tracheal sup- Tracheobronchomalacia in Down Syndrome J Med Cases.…”

Section: Discussionmentioning

confidence: 99%

“…portive tissue, sometimes tracheoplasty may be considered a better mode of intervention [6]. There still remains uncertainty whether these risk factors are increased in Down syndrome patients in comparison to the general population.…”

Section: Discussionmentioning

confidence: 99%

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Tracheobronchomalacia in a Down Syndrome Patient: A Fatal Anomaly

et al. 2015

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Down syndrome is a common chromosomal abnormality associated with many different structural anomalies. Tracheomalacia results in tracheal collapse when increased airflow is demanded due to the flaccidity of the tracheal support cartilage. Sufficient research and data are currently not available on airway malformations associated with Down syndrome, including tracheomalacia. In this case report, we discuss a Down syndrome patient with pneumonia found to have narrowing of his airway which resulted in prolonged hospital stay and difficulty in management. In most children with Down syndrome, tracheomalacia, tracheobronchomalacia, and bronchomalacia are all under diagnosed, yet these anomalies are more commonly missed in adults with Down syndrome. This can result from the patient's presentation, which tends to be non-specific, and unless a specific obstruction is considered, it is unlikely that such forms of narrowing will be discovered. Severe adult tracheomalacia is a severe condition that can be difficult to treat, especially when associated with an airway infection that may result in increased mortality rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Tracheobronchomalacia in a Down Syndrome Patient: A Fatal Anomaly

et al. 2015

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“…Спадение просвета трахеи более чем на 50% расценивали как значимое нарушение каркасной функции [1,7,10]. В зависимости от формы трахеи во время выдоха диагностировали ТМ.…”

Section: частота клинических симптомов у пациентов с рстunclassified

Evolution of diagnostic methods for cicatrical tracheal stenosis and tracheomalacia

2016

Khir. Z. im. N.I. Pirogova

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Ключевые слова: рубцовый стеноз трахеи, трахеомаляция, МСКТ, МРТ, резекция трахеи, трахеопластика, диагностика трахеи. Evolution of diagnostic methods for cicatrical tracheal stenosis and tracheomalaciaAim. to analyze the role of ray functional computerized diagnostic technologies in assessment of the state of tracheal wall in cicatricial stenosis. Material and methods. We examined 45 patients with cicatricial tracheal stenosis during August 2013 -march 2015. Fibrobronchoscopy, multislice computerized tomography, magnetic resonance imaging and lungs function examination were performed. For the first time dynamic (functional) Ct and mRi were included in research algorithm. these techniques have not been used for cicatricial stenosis and tracheomalacia in our country until this moment. Circular resection with anastomosis was made in 38 patients and stage reconstructions were preferred in 7 cases. Last ones had advanced tracheomalacia on the background of cicatrical stenosis that forced to abandon from tracheal resection. so time to treatment and incidence of complications and recurrences were reduced and the results were improved. Conclusion. endoscopy remains the main method of diagnosis of tracheal stenosis despite its invasiveness. Data of cicatrical transformation of tracheal wall per se can be obtained non-invasively using dynamic Ct and mRi. these techniques help to identify or exclude tracheomalacia. they potentially complement fibrobronchoscopy and may be preferable to assess perioperative intramural pathological changes of the trachea.

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“…It is a rare but underdiagnosed disease in intensive care units 1. The most common causes in adults include tracheostomy or endotracheal intubation, chronic inflammation or irritants and chronic external compression from a variety of aetiologies 2.…”

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confidence: 99%

All that wheezes is not asthma: adult tracheomalacia resulting from innominate artery compression

Keng¹,

Chang

2016

Postgraduate Medical Journal

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Severe Tracheomalacia in the ICU: Identification of Diagnostic Criteria and Risk Factor Analysis From a Case Control Study

Abstract: STM was associated with prolonged ICU stay. A distal tracheal antero-posterior diameter < 7 mm on a non-intubated CT chest was suggestive of STM that required a confirmatory bronchoscopy. Gastroesophageal reflux disease and obesity were potential risk factors.

Cited by 27 publications

References 29 publications

Tracheobronchomalacia in a Down Syndrome Patient: A Fatal Anomaly

Tracheobronchomalacia in a Down Syndrome Patient: A Fatal Anomaly

Evolution of diagnostic methods for cicatrical tracheal stenosis and tracheomalacia

All that wheezes is not asthma: adult tracheomalacia resulting from innominate artery compression

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