Abstract

CHAVEZ, Eliana et al. Tracheobronchomalacia as a cause of recurrent complete atelectasia of the left lung: A case report. An. Fac. Cienc. Méd. (Asunción) [online]. 2022, vol.55, n.1, pp.89-94. ISSN 1816-8949.  https://doi.org/10.18004/anales/2022.055.01.89.

Case report of a 55-year-old patient with an underlying history of asthma, COPD (Chronic Obstructive Pulmonary Disease) and congestive heart failure. 6 years ago, she was admitted at the intensive care unit, where she had a tracheostomy and subsequent decannulation. She attends due to an exacerbation of her underlying pathology, and then admitted to the Adult Intensive Care Department of the Hospital de Clinicas. Once at the intensive care department, a chest X-ray is performed where a complete collapse of the left lung is verified; reason why the patient is intubated and placed on mechanical ventilation. Respiratory physiotherapy is requested an attempt to resolve the atelectasis. Daily sessions of respiratory kinesic assistance (AKR), manual hyperinflation accompanied by positive pressure ventilatory support are made.

In the subsequent days, the resolution of the atelectasis was observed with daily radiographic controls, reason why a test for spontaneous ventilation (PVE) with a T-tube was made without success, due to a new left lung atelectasis. Reason why a bronchoscopy was requested where a collapse of the posterior wall of the left main bronchus and a weakness of the tracheal muscles (left tracheobronchomalacia) was observed.

Lastly, it is important to recognize tracheobronchomalacia as an infrequent pathology in adults; and that positive pressure support with respiratory kinesic assistance is recommended to avoid recurrences.

Keywords : Atelectasis; tracheobronchomalacia; respiratory physiotherapy; manual hyperinflation; intensive care..

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