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

Korean J Anesthesiol. 2022 Aug;75(4):350-353. doi: 10.4097/kja.21460. Epub 2022 Feb 22.

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.

Keywords: Airway management; Airway obstruction; Respiratory insufficiency; Respiratory tract diseases; Tracheal stenosis; Tracheitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Airway Extubation / adverse effects
  • Airway Obstruction* / diagnostic imaging
  • Airway Obstruction* / etiology
  • Airway Obstruction* / surgery
  • Female
  • Humans
  • Intubation, Intratracheal / adverse effects
  • Tracheal Diseases* / diagnosis
  • Tracheal Diseases* / etiology
  • Tracheal Diseases* / surgery
  • Tracheitis* / complications