Expiratory Central Airway Collapse in Adults: Anesthetic Implications (Part 1)

Abstract

Expiratory central airway collapse (ECAC) is a general term that incorporates tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC). TBM and EDAC are progressive, degenerative disorders of the tracheobronchial tree, causing airway collapse. Induction of general anesthesia can trigger intraoperative airway collapse in patients with these conditions. This crisis presents as the sudden inability to ventilate, which can lead to life-threatening hypoxemia and hypercapnia. This article reviews the definition, pathophysiology, diagnosis, and anesthetic implications of ECAC.

Keywords: excessive dynamic airway collapse; expiratory central airway collapse; hypoxemia; intraoperative airway collapse; tracheobronchomalacia.