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Excessive dynamic airway collapse for the internist: new nomenclature or different entity?
  1. Ankur Kalra1,
  2. Wissam Abouzgheib2,
  3. Mithil Gajera3,
  4. Chandrasekar Palaniswamy4,
  5. Nitin Puri3,
  6. Richard Phillip Dellinger3
  1. 1Division of Internal Medicine, Department of Medicine, Cooper University Hospital, UMDNJ-Robert Wood Johnson Medical School, Camden, New Jersey, USA
  2. 2Interventional Pulmonary, Sparks Health System, Fort Smith, Arkanas, USA
  3. 3Critical Care Medicine, Department of Medicine, Cooper University Hospital, UMDNJ-Robert Wood Johnson Medical School, Camden, New Jersey, USA
  4. 4Department of Medicine, New York Medical College, Westchester Medical Center, Valhalla, New York, USA
  1. Correspondence to Wissam Abouzgheib, Interventional Pulmonary, Fort Smith Lung Center, Sparks Health System, 1001 Towson Avenue, Fort Smith, Arkansas 72901, USA; wabouzgh{at}sparks.org

Abstract

Excessive dynamic airway collapse (EDAC) refers to abnormal and exaggerated bulging of the posterior wall within the airway lumen during exhalation. This condition is pathological if the reduced airway lumen is <50% of the normal. It is a relatively new disease entity that is recognised more easily now with the increased use of multi-detector row CT. EDAC is often asymptomatic and diagnosed incidentally. Although the term excessive dynamic airway collapse is often used interchangeably with tracheobronchomalacia, both entities represent morphologically and physiologically distinct processes. Considering the confusion between the two entities, the prevalence of stand-alone EDAC remains unclear. The prevalence of tracheobronchomalacia and EDAC depends upon the patient population, associated comorbidities and underlying aetiologies, diagnostic tools used and criteria used to define the airway collapse. This review defines EDAC and describes its pathophysiology, precipitating factors, associated symptoms and potential treatments.

  • Dynamic airway collapse
  • tracheobronchomalacia
  • DAC
  • TBM
  • adult intensive and critical care
  • respiratory medicine (see thoracic medicine)
  • bronchoscopy

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Footnotes

  • All the aforementioned authors had access to the data and a role in writing the manuscript.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.