<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1816-8949</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Ciencias Médicas (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[An. Fac. Cienc. Méd. (Asunción)]]></abbrev-journal-title>
<issn>1816-8949</issn>
<publisher>
<publisher-name><![CDATA[EFACIM. Editorial de la Facultad de Ciencias Médicas - Universidad Nacional de Asunción]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1816-89492022000100089</article-id>
<article-id pub-id-type="doi">10.18004/anales/2022.055.01.89</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Traqueobroncomalacia como causa de atelectasia completa recidivante del pulmón izquierdo: Reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Tracheobronchomalacia as a cause of recurrent complete atelectasia of the left lung: A case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chávez]]></surname>
<given-names><![CDATA[Eliana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[Ruth María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cristaldo]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ibarra]]></surname>
<given-names><![CDATA[Denixse]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fontclara]]></surname>
<given-names><![CDATA[Lorena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueredo]]></surname>
<given-names><![CDATA[Belinda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Departamento de Rehabilitación Cardiorrespiratoria, Kinesiología y Fisioterapia]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas, Departamento de Cuidados Intensivos Adultos]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<volume>55</volume>
<numero>1</numero>
<fpage>89</fpage>
<lpage>94</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1816-89492022000100089&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1816-89492022000100089&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1816-89492022000100089&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Se presenta el caso de una paciente de 55 años con enfermedad pulmonar obstructiva crónica (EPOC) de origen asmático e insuficiencia cardíaca congestiva, con antecedente de hospitalización en unidad de cuidados intensivos (UCI), 6 años antes, traqueostomizada con posterior decanulación. Acude a la consulta por exacerbación de su patología de base, quedando internada en el Departamento de Cuidados Intensivos Adultos del Hospital de Clínicas. Se decide intubación y ventilación mecánica; a la radiografía de tórax se constata colapso completo del pulmón izquierdo. Se solicita fisioterapia respiratoria para resolución de la atelectasia. Se realizan sesiones diarias de asistencia kinésica respiratoria (AKR), maniobras de hiperinsuflación manual acompañadas de soporte ventilatorio a presión positiva. En los siguientes días, luego de controles radiográficos se observa la resolución de la atelectasia y se decide someterla a pruebas de ventilación espontánea (PVE) con tubo T sin éxito, por re-colapso pulmonar subtotal, y luego colapso total del pulmón izquierdo. Se solicita realización de una fibrobroncoscopía en la cual se observa un colapso de la pared posterior del bronquio fuente principal izquierdo y debilidad de la musculatura de la tráquea (traqueobroncomalacia izquierda). Es importante el reconocimiento de la traqueobroncomalacia como patología poco frecuente en adultos y se recomienda el soporte a presión positiva más AKR para evitar recidivas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT 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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Atelectasia]]></kwd>
<kwd lng="es"><![CDATA[traqueobroncomalacia]]></kwd>
<kwd lng="es"><![CDATA[fisioterapia respiratoria]]></kwd>
<kwd lng="es"><![CDATA[hiperinsuflación manual]]></kwd>
<kwd lng="es"><![CDATA[cuidados intensivos.]]></kwd>
<kwd lng="en"><![CDATA[Atelectasis]]></kwd>
<kwd lng="en"><![CDATA[tracheobronchomalacia]]></kwd>
<kwd lng="en"><![CDATA[respiratory physiotherapy]]></kwd>
<kwd lng="en"><![CDATA[manual hyperinflation]]></kwd>
<kwd lng="en"><![CDATA[intensive care.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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