Baby on ventilator developed condition called bronchial malasia/bronchomalacia what is this condition and why?

baby is 3 months old has had 2 open heart surgeries and been on the ventilator for 3 weeks now. The baby was breathing over the ventilator and is recovering well from the open heart surgeries. The dr took the ventilator out and said the baby seems to be taking air in but not breathing it out. The Dr. said the baby may have to be trached, the baby also was breathing fine on his own prior to the surgeries. The Dr. claimed this was just a minor set back and could be treated.

Your airways (like your trachea and the big main bronchii) have little rings of cartilage that hold them open. Sometimes those rings are too soft to hold the airway open and the airway (in your baby's case, it would be in the bronchii) can collapse on itself. That is what is meant by bronchomalacia.

I have taken care of very premature infants who had bouts of tracheomalacia (the rings of cartilage in the trachea were weak and couldn't hold the trachea open from time to time--especially when the baby was agitated, in pain or stressed). The way we treated the episodes of tracheomalacia was to manually provide positive pressure breaths with a resuscitation bag and mask.

If a baby doesn't grow out of this problem, it can be fixed by placing a stent in the airway to basically do what the cartilage rings are suppsed to do. Other times, it can be managed by using a continuous positive airway pressure machine (CPAP) to keep a constant level of pressure against the airways so they stay open.

You say he was breathing normally before the intubation, so the other answer isn't accurate because this is not a congenital problem.
In this baby's case, the endotracheal tube has probably rubbed on the inside of the trachea and the bronchus where the end of the tube has been. This will cause scarring which can require surgery to get rid of the scar tissue. It can usually be done endoscopically without an external incision.
I question why this baby wasn't trached after being on the ventilator longer than 10 days, but I'm sure they have their reasons. It would be a bit unusual, though.
Bronchotracheomalacia is a minor setback-- the doc is right.

i just love how a speech therapist thinks she knows more that a NICU nurse ... LMAO ........