# Airway closure in a patient with acute heart failure: a case report

## TL;DR

This case report describes a patient with heart failure who developed airway closure, leading to severe lung issues and requiring careful ventilator adjustments.

## Contribution

The report highlights airway closure as a potential complication in acute heart failure and demonstrates a practical method for identifying and managing it.

## Key findings

- Airway closure was identified in a patient with acute heart failure and pulmonary edema.
- A low-flow inflation procedure helped detect airway closure and guide ventilator settings.
- Positive end-expiratory pressure was adjusted based on airway opening pressure to improve outcomes.

## Abstract

Airway closure occurs in small airways and disconnects distal airways from proximal airways. This pathology may lead to acute pulmonary edema, worsening gas exchange and creating challenges in ventilator management.

We report the case of a 68-year-old woman who was admitted to the hospital because of non-ST elevation acute myocardial infarction and was subsequently intubated because of refractory pulmonary edema. The low-flow inflation procedure revealed airway closure, and the positive end-expiratory pressure was titrated according to the airway opening pressure.

Acute pulmonary edema may be accompanied by airway closure. A simple bedside procedure can indicate the presence of this complication and guide positive end-expiratory pressure setting.