Obstructive Fibrinous Tracheal Pseudomembrane: An Update

Manassero, Alberto; Bossolasco, Matteo

doi:10.4266/kjccm.2014.29.3.241

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Spontaneous expectoration of the membrane was seen in 6 subjects (5 adults, one child). 9,21,26,28,31 Recurrence of symptoms and repeated formation of the tracheal membrane was encountered in 2 subjects (both adults). 4 There were 2 deaths (one each in adult and pediatric subjects): One was due to progression of sepsis, and in another subject, tracheal pseudomembrane was not identified premortem.…”

Section: Management Of Oftpmentioning

confidence: 99%

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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Section: Management Of Oftpmentioning

confidence: 99%

Obstructive Fibrinous Tracheal Pseudomembrane After Endotracheal Intubation

Sehgal¹,

Dhooria²,

Bal

et al. 2016

Respir Care

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“…Risk factors may include female gender, tracheal tube cuff pressure >25cmH2O, traumatic intubation, use of double-lumen endotracheal tube, prolonged endotracheal intubation, airway stenting, immunocompromised host, bacterial or fungal infection [1,2,[6][7][8][9][10][11][12][13][14][15][16]. Additionally, aspiration of gastric contents leading to caustic injury has also been proposed as a contributory factor to the formation of OFPT after the initial disruption to the tracheal mucosa, followed by abnormal healing process [1,14].…”

Section: Discussionmentioning

confidence: 99%

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

Chua

Sim

Theng

et al. 2022

Korean J Anesthesiol

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Background: Obstructive fibrinous pseudomembrane tracheitis [OFPT] is a rare complication of endotracheal intubation. Case:We describe a 73-year-old woman who had undergone a short duration of intubation for video-assisted thoracotomy and developed acute life-threatening stridor 2 days after extubation from OFPT. She required emergency tracheostomy to maintain airway patency and bronchoscopy for removal of the obstructing pseudomembrane. She also suffered a non-ST elevation myocardial infarction as a result of this episode. She recovered and the tracheostomy was subsequently decannulated after a few weeks. Histology returned to reveal mucosal ulceration and inflammatory changes. Conclusions:OFPT is an uncommon cause of life-threatening airway obstruction after extubation that is often not immediately recognized, but is usually readily treatable with early bronchoscopic intervention.

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“…It is hypothesized that OFTP is a consequences of tracheal ischemic injury which lead to mucosal injury. This cause desquamation and necrosis of the tracheal epithelium in addition to polymorphonuclear cells infiltration; and subsequently fibrinous material formation [53,54]. OFTP has been reported in patients intubated with different types of ETT including cuffed rubber tubes, double lumen tube, and cuffed and uncuffed silicone tubes.…”

Section: Tracheal Intubationmentioning

confidence: 99%

“…OFTP has been reported in patients intubated with different types of ETT including cuffed rubber tubes, double lumen tube, and cuffed and uncuffed silicone tubes. Clinical studies have suggested several risk factors such as increase pressure of ETT cuff, usage of large tracheal tubes, traumatic intubation and prolonged intubation [54]. Presence of one or more of the previously mentioned risk factors is not absolutely necessary for OFTP to develop.…”

Section: Tracheal Intubationmentioning

confidence: 99%

Long-Term Complications of Tracheal Intubation

Touman¹,

Stratakos²

2018

Tracheal Intubation

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Endotracheal intubation is an intervention frequently performed in the hospital setting in order to protect the central airway and provide mechanical support of ventilation. Many health care providers are expected to be able to intubate the patients for different indications. As the case in any medical intervention, endotracheal intubation can cause complications. These complications are categorized as early or late according to the time of onset of the presenting symptoms. This chapter will discuss the long term complications of endotracheal intubation that might be encountered by the treating physicians. The chapter will stress on the predisposing factors for these complications and the available methods to avoid and treat them.

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Obstructive Fibrinous Tracheal Pseudomembrane: An Update

Cited by 3 publications

References 3 publications

Obstructive Fibrinous Tracheal Pseudomembrane After Endotracheal Intubation

Obstructive Fibrinous Tracheal Pseudomembrane After Endotracheal Intubation

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

Long-Term Complications of Tracheal Intubation

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