• A&A practice · Jan 2020

    Case Reports

    Dynamic Tracheobronchial Compression in Steep Trendelenburg Position With Pneumoperitoneum for Robotic-Assisted Cystectomy: A Case Report.

    • Lenard W Babus and Daniel M Gainsburg.
    • From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine, The Mount Sinai Hospital, New York, New York.
    • A A Pract. 2020 Jan 1; 14 (1): 18-20.

    AbstractTracheobronchomalacia is a weakness of the trachea and bronchi due to abnormal cartilage and muscular support leading to airway obstruction. We report a case of an adult former smoker without pulmonary symptoms who underwent robotic-assisted laparoscopic cystectomy in the steep Trendelenburg position. After repeated episodes of hypoxemia, bronchoscopic examination revealed collapse of the distal trachea and bronchi, supporting a diagnosis of tracheobronchomalacia. Tracheomalacia is an underdiagnosed condition in patients with a smoking history and may mimic other obstructive diseases. The anesthesiologist should remain vigilant to the possibility of airway collapse in former smokers, specifically in cases of increased intrathoracic pressure.

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