Airway obstruction

Blockage in the respiratory system

Medical condition

Airway obstruction

Specialty| Pulmonology

Airway obstruction is a blockage of respiration in the airway that hinders the free flow of air. It can be broadly classified into being either in the upper airway (UPA) or lower airway (LOA).

Airway obstruction is a life-threatening condition and requires urgent attention, and assistance when it is needed.[1] The assistance to clear an upper airway obstruction would begin employing first-aid anti-choking techniques.

## Upper airway obstruction

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Further information: Choking

Causes of upper airway obstruction include foreign body aspiration, blunt laryngotracheal trauma, penetrating laryngotracheal trauma, tonsillar hypertrophy, paralysis of the vocal cord or vocal fold, acute laryngotracheitis such as viral croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, pertussis, retropharyngeal abscess, spasmodic croup.[2] In basic and advanced life support airway obstructions are often referred to as A-problems. Management of airways relies on both minimal-invasive and invasive techniques.

## Lower airway obstruction

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Further information: Obstructive lung disease

Lower airway obstruction is mainly caused by increased resistance in the bronchioles (usually from a decreased radius of the bronchioles) that reduces the amount of air inhaled in each breath and the oxygen that reaches the pulmonary arteries. It is different from airway restriction (which prevents air from diffusing into the pulmonary arteries because of some kind of blockage in the lungs). Diseases that cause lower airway obstruction are termed obstructive lung diseases.[3]

Lower airway obstruction can be measured using spirometry. A decreased FEV1/FVC ratio (versus the normal of about 80%) is indicative of airway obstruction, as the normal amount of air can no longer be exhaled in the first second of expiration. An airway restriction would not produce a reduced FEV1/FVC ratio, but would reduce the vital capacity. The ventilation is therefore affected leading to a ventilation-perfusion mismatch and hypoxia.

## Consequences

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Airway obstruction may cause obstructive pneumonitis or post-obstructive pneumonitis. It can also be a sign of chronic obstructive pulmonary disease (COPD), a common breathing disorder that is a risk factor for lung cancer.[4][5]

## See also

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* Stridor
* Recurrent airway obstruction

## References

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1. ^ Aboussouan, L.S.; Stoller, J.K (15 March 1994). "Diagnosis and management of upper airway obstruction". Clinics in Chest Medicine. 15 (1): 35–53. doi:10.1016/S0272-5231(21)01054-6. PMID 8200192. Archived from the original on 25 June 2021. Retrieved 25 June 2021.
2. ^ Respiratory Emergencies, section Acute Upper Airway Obstruction[permanent dead link]. From FP Essentials 368 Archived 2020-03-14 at the Wayback Machine. January 2010 by American Academy of Family Physicians.
3. ^ "Airway Obstruction". The Lecturio Medical Concept Library. Archived from the original on 2021-06-25. Retrieved 2021-06-25.
4. ^ "Lung health checks in supermarket car parks reach older smokers in deprived communities". NIHR Evidence (Plain English summary). 2020-08-05. doi:10.3310/alert_40661. S2CID 243394660. Archived from the original on 2022-03-14. Retrieved 2024-07-01.
5. ^ Balata, Haval; Harvey, Jonathan; Barber, Phil V; Colligan, Denis; Duerden, Rebecca; Elton, Peter; Evison, Matthew; Greaves, Melanie; Howells, John; Irion, Klaus; Karunaratne, Devinda (15 Jul 2020). "Spirometry performed as part of the Manchester community-based lung cancer screening programme detects a high prevalence of airflow obstruction in individuals without a prior diagnosis of COPD". Thorax. 75 (8): 655–660. doi:10.1136/thoraxjnl-2019-213584. ISSN 0040-6376. PMID 32444437. S2CID 218855570. Archived from the original on 22 May 2022. Retrieved 1 July 2024.

## External links

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Classification|

* MeSH: D000402

|

* v
* t
* e

Diseases of the respiratory system

Upper RT
(including URTIs,
common cold)|

| Head|

sinuses

Sinusitis

nose

Rhinitis

Vasomotor rhinitis
Atrophic rhinitis
Hay fever
Nasal polyp
Rhinorrhea
nasal septum

Nasal septum deviation
Nasal septum perforation
Nasal septal hematoma

tonsil

Tonsillitis
Adenoid hypertrophy
Peritonsillar abscess

|

Neck|

pharynx

Pharyngitis

Strep throat
Laryngopharyngeal reflux (LPR)
Retropharyngeal abscess

larynx

Croup
Laryngomalacia
Laryngeal cyst
Laryngitis
Laryngopharyngeal reflux (LPR)
Laryngospasm

vocal cords

Laryngopharyngeal reflux (LPR)
Vocal fold nodule
Vocal fold paresis
Vocal cord dysfunction

epiglottis

Epiglottitis

trachea

Tracheitis
Laryngotracheal stenosis

Lower RT/
lung disease
(including LRTIs)|

| Bronchial/
obstructive|

acute

Acute bronchitis

chronic

COPD

Chronic bronchitis
Acute exacerbation of COPD)
Asthma (Status asthmaticus
AERD
Exercise-induced
Bronchiectasis
Cystic fibrosis

unspecified

Bronchitis
Bronchiolitis

Bronchiolitis obliterans
Diffuse panbronchiolitis

|

Interstitial/
restrictive
(fibrosis)|

| External agents/
occupational
lung disease|

Pneumoconiosis

Aluminosis
Asbestosis
Baritosis
Bauxite fibrosis
Berylliosis
Caplan's syndrome
Chalicosis
Coalworker's pneumoconiosis
Siderosis
Silicosis
Talcosis
Byssinosis

Hypersensitivity pneumonitis

Bagassosis
Bird fancier's lung
Farmer's lung
Lycoperdonosis

|

Other|

* ARDS
* Combined pulmonary fibrosis and emphysema
* Pulmonary edema
* Löffler's syndrome/Eosinophilic pneumonia
* Respiratory hypersensitivity
* Allergic bronchopulmonary aspergillosis
* Hamman–Rich syndrome
* Idiopathic pulmonary fibrosis
* Sarcoidosis
* Vaping-associated pulmonary injury

Obstructive /
Restrictive|

| Pneumonia/
pneumonitis|

| By pathogen|

* Viral
* Bacterial
* Pneumococcal
* Klebsiella
* Atypical bacterial
* Mycoplasma
* Legionnaires' disease
* Chlamydiae
* Fungal
* Pneumocystis
* Parasitic
* noninfectious
* Chemical/Mendelson's syndrome
* Aspiration/Lipid

|

By vector/route|

* Community-acquired
* Healthcare-associated
* Hospital-acquired

By distribution|

* Broncho-
* Lobar

IIP|

* UIP
* DIP
* BOOP-COP
* NSIP
* RB

Other|

* Atelectasis
* circulatory
* Pulmonary hypertension
* Pulmonary embolism
* Lung abscess

Pleural cavity/
mediastinum|

| Pleural disease|

* Pleuritis/pleurisy

* Pneumothorax/Hemopneumothorax

Pleural effusion

Hemothorax
Hydrothorax
Chylothorax
Empyema/pyothorax
Malignant

Fibrothorax

|

Mediastinal disease|

* Mediastinitis
* Mediastinal emphysema

Other/general|

* Respiratory failure
* Influenza
* Common cold
* SARS
* COVID-19
* Idiopathic pulmonary haemosiderosis
* Pulmonary alveolar proteinosis

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