Draft

24  ECAC

24.1 What this covers

  • Excessive (or expiratory) dynamic airway collapse of the posterior membrane (EDAC)
  • Tracheobronchomalacia (TBM)
  • aka expiratory central airway collapse.

24.2 Learning objectives

  • Excessive (or expiratory) dynamic airway collapse of the posterior membrane (EDAC)
  • Tracheobronchomalacia (TBM)
  • aka expiratory central airway collapse.
  • Reference: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30258-5/fulltext
  • Often comorbid COPD, GERD/LPR, autoimmune/RP. ICS postulated to be causal in some cases.
  • Presentation: nonspecific - ‘seal-bark like cough’, impaired secretion clearance.
  • PFT may be obstructive (45%), restrictive (20%) or normal (20%)

24.3 Bottom line / summary

  • aka expiratory central airway collapse.
  • Reference: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30258-5/fulltext
  • Often comorbid COPD, GERD/LPR, autoimmune/RP.
  • ICS postulated to be causal in some cases.
  • Presentation: nonspecific - ‘seal-bark like cough’, impaired secretion clearance.

24.4 Approach

  1. ECAC
  2. Excessive (or expiratory) dynamic airway collapse of the posterior membrane (EDAC)
  3. Tracheobronchomalacia (TBM)

24.5 Red flags / when to escalate

  • TODO: List red flags that require urgent escalation.

24.6 Common pitfalls

  • TODO: Capture common errors or missed steps.

24.7 References

  • https://www.mayoclinicproceedings.org/article/S0025-6196(20)30258-5/fulltext
  • https://photos.collectednotes.com/photos/5187/54348f54-151d-4bda-bfe2-19717d33dbc1

24.8 Source notes

24.8.1 ECAC

25 ECAC

aka expiratory central airway collapse.

Reference: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30258-5/fulltext

Often comorbid COPD, GERD/LPR, autoimmune/RP. ICS postulated to be causal in some cases.

Presentation: nonspecific - ‘seal-bark like cough’, impaired secretion clearance.

PFT may be obstructive (45%), restrictive (20%) or normal (20%)

alt

25.1 Excessive (or expiratory) dynamic airway collapse of the posterior membrane (EDAC)

normal = 50 +/- 20% luminal collapse on forced expiration. 70+% is excessive

25.2 Tracheobronchomalacia (TBM)

abnormal movement of cartilagenous wall (anterior). Can be cartilagenous (splaying at the end of the tracheal cartilage) or circumfrential (e.g. in relapsing polychondritis)

25.3 Source materials