Korean J Anesthesiol.  2022 Aug;75(4):350-353. 10.4097/kja.21460.

Obstructive fibrinous pseudomembrane tracheitis after double-lumen tube intubation -a case report-

Affiliations
  • 1Division of Anesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore
  • 2Department of Otorhinolaryngology - Head & Neck Surgery, Singapore General Hospital, Singapore
  • 3Department of Cardiothoracic Surgery, National Heart Center, Singapore
  • 4Division of Anesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore

Abstract

Background
Obstructive fibrinous pseudomembrane tracheitis (OFPT) is a rare complication of endotracheal intubation. Case: We describe the case of a 73-year-old woman who underwent short-term intubation for video-assisted thoracoscopic surgery and developed an acute life-threatening stridor two days after extubation. The patient required an emergency tracheostomy to maintain airway patency and a microscopic direct laryngoscopy procedure was performed thereafter with removal of the obstructive pseudomembrane. Subsequently, the patient also suffered a non-ST-elevation myocardial infarction. The patient successfully recovered, and the tracheostomy was subsequently decannulated two months later. Histological examination revealed mucosal ulcerations and inflammatory changes.
Conclusions
OFPT is an uncommon cause of life-threatening airway obstruction after extubation that is not often recognized immediately but can usually be treated with early bronchoscopic intervention or microscopic direct laryngoscopy.

Keyword

Airway management; Airway obstruction; Respiratory insufficiency; Respiratory tract diseases; Tracheal stenosis; Tracheitis
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