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Airway obstruction

Alexey Kryvenko, medical expert
Last reviewed: 05.07.2025

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Airway obstruction is divided into upper and lower airway obstruction.

With massive aspiration of any substrate, asphyxial syndrome develops, in which the main damaging factor is mechanical obstruction of the trachea, bronchi and bronchioles.

Such conditions, depending on the nature and amount of aspiration, can pose an immediate threat to the patient’s life (partial or complete obstruction of the airways) or contribute to the development of a pulmonary infection in the long term (stagnation of bronchial secretions, atelectasis).

Chemical injury usually develops only when the pH of the aspirated fluid is low or when other aggressive factors are present in it.

Large foreign bodies can obstruct the larynx or trachea, causing aphonia, cyanosis, acute respiratory failure, loss of consciousness and sudden death.

In partial tracheal obstruction, two-phase stridor breathing with expiratory wheezing is observed. As the foreign body moves distally, inspiratory stridor becomes less pronounced.

When a foreign body is found in the main bronchus, unilateral wheezing is heard (due to air flow turbulence and reflex bronchospasm).

In case of obstruction of a lobar or segmental bronchus, auscultation reveals asymmetry of breathing and local wheezing. The weakening of breathing can be used to indirectly judge the localization of the aspiration area and the development of atelectasis.

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What causes airway obstruction?

The causes of airway obstruction are various diseases and injuries. In cases where the obstruction of gas flow during breathing occurs in the oral cavity, pharynx or larynx, respiratory disorders are considered in connection with the obstruction of the upper airways, below the larynx - obstruction of the lower airways. Obstruction causes a total disorder of gas exchange - asphyxia, leading in some cases to a fatal outcome.

Causes of Upper Airway Obstruction

Congenital diseases

Acquired diseases and injuries

Narrowing of the internal lumen of the airways:

Subglottic stenosis;

Membrane;

Cyst;

Laryngocele;

Tumor;

Laryngomalacia;

Laryngotracheoesophageal membrane;

Tracheomalacia;

Gracheoesophageal fistula.

External compression and damage:

Vascular ring;

Cystohygroma.

Birth trauma.

Neurological disorders.

Anomalies of the craniofacial region.

Hypocalcemia

Infections:

Retropharyngeal abscess;

Ludwig's angina;

Laryngotracheobronchitis;

Epiglottitis;

Fungal infection;

Peritonsillar abscess;

Diphtheria;

Bacterial tracheitis.

Injury:

Lostintubation edema;

Posttracheostomy stenosis.

Burns of the respiratory tract (thermal or chemical).

Aspiration of foreign bodies.

Systemic disorders.

Tumors.

Neurological damage.

Chronic upper airway obstruction.

Hypertrophic tonsillitis and adenoids

In acute respiratory diseases, the leading role is played by the disruption of external respiration with the subsequent development of respiratory hypoxemia.

General principles of treatment of acute airway obstruction in children depending on the specific pathological condition: restoration of upper respiratory tract patency, elimination of bronchial obstruction, correction of metabolic disorders, antibacterial therapy, if necessary, tracheal intubation and mechanical ventilation.