An Unusual Case of Stridor: Obstructive Fibrinous Tracheal Pseudomembrane

Rice, Brenda L.; Culver, Daniel A.; Lazar, Catherine A.; Santacruz, Jose F.; McCarthy, Kevin; Gildea, Thomas R.

doi:10.1378/chest.10299

Cited by 2 publications

(1 citation statement)

References 1 publication

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“…Since then, only about 30 cases have been reported worldwide. [2][3][4][5][6][7][8][9] The condition presents clinically as stridor or respiratory insufficiency after extubation. It is certainly difficult to differentiate OFTP from other conditions because laryngeal spasm, edema, and the retention of secretions also present with stridor or respiratory insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Obstructive Fibrinous Tracheal Pseudomembrane Presented with Atelectasis

Lee

Park

et al. 2014

Korean J Crit Care Med

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Obstructive fibrinous tracheal pseudomembrane (OFTP) is a rare condition usually associated with endotracheal intubation. Airway obstruction caused by OFTP may occur after endotracheal tube extubation and can lead to severe respiratory distress. It is a rare but potentially fatal complication. In this report, we present a case of OFTP presented with atelectasis that caused dyspnea after extubation and was successfully treated by mechanical removal using a rigid bronchoscope.

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Section: Discussionmentioning

confidence: 99%

Obstructive Fibrinous Tracheal Pseudomembrane Presented with Atelectasis

Lee

Park

et al. 2014

Korean J Crit Care Med

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Obstructive Fibrinous Tracheal Pseudomembrane After Endotracheal Intubation

Sehgal¹,

Dhooria²,

Bal

et al. 2016

Respir Care

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Obstructive fibrinous tracheal pseudomembrane (OFTP) is an uncommon complication that results after tracheal intubation. Herein, we perform a systematic review of the PubMed and EmBase databases for all the cases describing OFTP. The systematic search yielded 28 citations describing 53 subjects with OFTP. The study population (61.1% females) comprised of both adults and pediatric subjects with a median (IQR) age of 40.5 (14.8 -60.5) years. The median (IQR) size of endotracheal tube was 7.5 (6 -9.3) mm with a median (IQR) duration of intubation of 36 (14 -96) hours. The median (IQR) time to onset of symptoms after extubation was 24 (6 -96) hours. Stridor was the most common symptom. The average delay in correctly identifying the OFTP was 26 hours. The diagnosis of tracheal pseudomembrane was confirmed by flexible bronchoscopy in 38 (70.4%) instances while rigid bronchoscopy was used in 46.3% subjects for removing the pseudomembrane. There were two deaths, one each in an adult and a pediatric subject. OFTP is a complication of tracheal intubation and presents with respiratory failure. The diagnosis can be confirmed by flexible bronchoscopy. Treatment involves removal of the obstructing membrane with either flexible or rigid bronchoscopy.

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An Unusual Case of Stridor: Obstructive Fibrinous Tracheal Pseudomembrane

Cited by 2 publications

References 1 publication

Obstructive Fibrinous Tracheal Pseudomembrane Presented with Atelectasis

Obstructive Fibrinous Tracheal Pseudomembrane Presented with Atelectasis

Obstructive Fibrinous Tracheal Pseudomembrane After Endotracheal Intubation

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