Barotrauma as aetiological cascade of fatal intrapulmonary plastic bronchitis in a post-Fontan child

Abstract

The role of barotrauma in the exaggeration of plastic bronchitis after Fontan circulation has yet to be examined. We aim to describe a case of a 4-year old post-Fontan circulation girl where barotrauma suffered during commercial air travel played a role in the aetiological cascade of plastic bronchitis.

Reappraisal of lung manifestations in the setting of Fontan circulation

“…36 Another hypothesis is mucus hyper-secretion triggered by elevated pulmonary venous pressures. 37 Additionally, the role of inflammation in patients with prolonged chest tube drainage has been proposed, and patients with increased perioperative bearing more risk of developing plastic bronchitis. 35 Barotrauma has been also suggested as etiological cascade of fatal intrapulmonary plastic bronchitis.…”

“…35 Barotrauma has been also suggested as etiological cascade of fatal intrapulmonary plastic bronchitis. 37 The diagnosis is often followed by repeated hospitalizations and a 5-year mortality as high as 50%. 37 CT is useful to identify airway and lung abnormalities, guide bronchoscopy and monitor treatment responses.…”

“…37 The diagnosis is often followed by repeated hospitalizations and a 5-year mortality as high as 50%. 37 CT is useful to identify airway and lung abnormalities, guide bronchoscopy and monitor treatment responses. Early diagnosis and aggressive treatment with simultaneous use of pulmonary vasodilators (sildenafil, bosentan), aerosolized fibrinolytics, mucolytics, and inhaled steroids can improve the outcome of these patients, although the duration of the efficacy of treatment remains unknown.…”

“…35 Barotrauma has been also suggested as etiological cascade of fatal intrapulmonary plastic bronchitis. 37…”