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- Title
Excessive dynamic airway collapse during general anesthesia: a case report.
- Authors
Murakami, Shunichi; Tsuruta, Shunsuke; Ishida, Kazuyoshi; Yamashita, Atsuo; Matsumoto, Mishiya
- Abstract
Background: Excessive dynamic airway collapse (EDAC) is an uncommon cause of high airway pressure during mechanical ventilation. However, EDAC is not widely recognized by anesthesiologists, and therefore, it is often misdiagnosed as asthma. Case presentation: A 70-year-old woman with a history of asthma received anesthesia with sevoflurane for a laparotomic cholecystectomy. Under general anesthesia, she developed wheezing, high inspiratory pressure, and a shark-fin waveform on capnography, which was interpreted as an asthma attack. However, treatment with a bronchodilator was ineffective. Bronchoscopy revealed the collapse of the trachea and main bronchi upon expiration. We reviewed the preoperative computed tomography scan and saw bulging of the posterior membrane into the airway lumen, leading to a diagnosis of EDAC. Conclusions: Although both EDAC and bronchospasm present as similar symptoms, the treatments are different. Bronchoscopy proved useful for distinguishing between these two entities. Positive end-expiratory pressure should be applied and bronchodilators avoided in EDAC.
- Subjects
GENERAL anesthesia; POSITIVE end-expiratory pressure; ATELECTASIS; SYMPTOMS; COMPUTED tomography
- Publication
JA Clinical Reports, 2020, Vol 6, Issue 1, pN.PAG
- ISSN
2363-9024
- Publication type
Article
- DOI
10.1186/s40981-020-00380-1