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Original Research: INTERVENTIONAL PULMONOLOGY |

A Novel Animal Model for Hyperdynamic Airway Collapse

Hisashi Tsukada, MD, PhD; Carl R. O’Donnell, ScD; Robert Garland, RRT; Felix Herth, MD, FCCP; Malcolm DeCamp, MD, FCCP; Armin Ernst, MD, FCCP
Author and Funding Information

From the Chest Disease Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA.

Correspondence to: Armin Ernst MD, FCCP, Caritas Christi Health Care, Seton 6 E, 736 Cambridge St, Boston, MA 02135; e-mail: armin.ernst@caritaschristi.org


Dr Ernst is currently at the St Elizabeth Medical Center and Caritas Christi Health Care, Boston, MA.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(6):1322-1326. doi:10.1378/chest.10-0165
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Objective:  Tracheobronchomalacia (TBM) is increasingly recognized as a condition associated with significant pulmonary morbidity. However, treatment is invasive and complex, and because there is no appropriate animal model, novel diagnostic and treatment strategies are difficult to evaluate. We endeavored to develop a reliable airway model to simulate hyperdynamic airway collapse in humans.

Methods:  Seven 20-kg male sheep were enrolled in this study. Tracheomalacia was created by submucosal resection of > 50% of the circumference of 10 consecutive cervical tracheal cartilage rings through a midline cervical incision. A silicone stent was placed in the trachea to prevent airway collapse during recovery. Tracheal collapsibility was assessed at protocol-specific time points by bronchoscopy and multidetector CT imaging while temporarily removing the stent. Esophageal pressure and flow data were collected to assess flow limitation during spontaneous breathing.

Results:  All animals tolerated the surgical procedure well and were stented without complications. One sheep died at 2 weeks because of respiratory failure related to stent migration. In all sheep, near-total forced inspiratory airway collapse was observed up to 3 months postprocedure. Esophageal manometry demonstrated flow limitation associated with large negative pleural pressure swings during rapid spontaneous inhalation.

Conclusions:  Hyperdynamic airway collapse can reliably be induced with this technique. It may serve as a model for evaluation of novel diagnostic and therapeutic strategies for TBM.

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