Respiratory distress in patients with central airway obstruction

Abstract

Introduction

Patients with respiratory distress due to central airway obstruction (Trachea, carina or main bronchi) are critically ill with impending suffocation. This obstruction is caused by a variety of benign and malignant causes that might be intraluminal, extra luminal or combined.

Patients and methods

This retrospective study conducted between 2002 and 2009, and included 56 patients presented with variable degrees of respiratory distress due to central airway obstruction. There were 37 male and 19 female, aged 3 weeks to 67 years. There were 31 benign causes (55.35%) and 25 malignant causes (44.65%). The site of the obstruction was intra luminal in 20 cases (35.7%), extra luminal in 24cases (42.85%) and combined in 12 cases (21.4%).Urgent bronchoscopic evaluation of the airways was required in all cases.

Results

Interventional bronchoscopic procedures were done in 35 cases (62.5%); including removal of foreign bodies, core-out of tumors, suction, dilatation, removal of granulation tissue and stenting. Surgical intervention was required in 36 cases (64.3%). Two patients refused surgical management. There were four (7.14%) mortalities.

Conclusion

Although the definitive management of central airway obstruction is surgical intervention, which provides the best opportunity, the bronchoscopic management is the first step to provide a diagnosis, stabilize the airways and evaluate resectability.