PDF(Pubmed)
Abstract：
Expiratory Central Airway Collapse (ECAC) is a multifactorial, underdiagnosed entity that poses unique challenges. Airway stenting is used as a predictor for successful outcomes after central airway stabilization surgery via tracheobronchoplasty (TBP). This approach may pose suboptimal performance in certain ECAC variants. We hypothesize that Continuous Positive Airway Pressure (CPAP), used as a pneumatic stent, could be a non-invasive alternative to evaluate surgical candidacy in cough-predominant ECAC presentations. We report on a 67-year-old female with a history of chronic cough and confirmed ECAC. After optimization of medical therapy without significant relief and unsuccessful stent trial. We opted to perform CPAP trial during exercise, the patient exercised on a treadmill, and CPAP was applied at two levels (9 cmH2O, 11 cmH2O). The use of CPAP was associated with resolution of cough and a decrease in exercise-related perceived exertion. Applying CPAP during exercise may be a promising alternative to stent trials to determine patients\' candidacy for surgical management of cough-predominant ECAC.
摘要：
呼气中央气道塌陷(ECAC)是一个多因素的，诊断不足的实体，构成独特的挑战。通过气管支气管成形术（TBP）进行中央气道稳定手术后，气道支架置入术可作为成功预后的预测指标。这种方法可能会在某些ECAC变体中造成次优性能。我们假设持续气道正压通气(CPAP)，用作气动支架，在以咳嗽为主的ECAC表现中,可能是评估手术候选性的非侵入性替代方法。我们报告了一名67岁的女性，有慢性咳嗽病史，并确诊了ECAC。经过优化的药物治疗，没有明显的缓解和不成功的支架试验。我们选择在运动期间进行CPAP试验，病人在跑步机上锻炼，CPAP在两个水平(9cmH2O，11cmH2O)。CPAP的使用与咳嗽的消退和运动相关的感觉劳累的减少有关。在运动过程中应用CPAP可能是支架试验的一种有希望的替代方法，以确定患者是否可以接受咳嗽为主的ECAC的手术治疗。
