Tussis for Obstructive Stridor, an Impromptu Cure: A Rare Case of Spontaneous Resolution of Obstructive Fibrinous Tracheal Pseudomembrane (OFTP).

Abolfazl Ahmady,Rama Kanth Pata,Roudabeh Kiani,Oday Alhafidh

doi:10.7759/cureus.12699

Abolfazl Ahmady, Rama Kanth Pata + Show 2 more

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https://doi.org/10.7759/cureus.12699

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Journal: Cureus	Publication Date: Jan 14, 2021
License type: cc-by

Affiliation: Brooklyn Hospital Center, New York University

Abstract

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a relatively rare complication of endotracheal intubation. OFTP, which may cause fatal airway obstruction, is perhaps more common than reported in the literature. Although little is known about the mechanisms that play a role in the development of OFTP, it is hypothesized that OFTP results from ischemic injury to tracheal mucosa. Diagnosis is made using rigid bronchoscopy, which is also used for excision and removal of the pseudomembrane. Here we present a case of OFTP in a patient who was intubated for three days, developed symptoms three days after extubation, and ultimately spontaneously expelled the tracheal pseudomembrane.

Highlights

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a relatively rare complication of endotracheal intubation
Little is known about the mechanisms that play a role in the development of OFTP, it is hypothesized that flawed intubation or extubation causes ischemic injury to the tracheal mucosa
This ischemia may be a result of an overinflated cuff of the endotracheal tube (ETT) or hypoperfusion and accentuated by a caustic injury caused by vomiting [1]

Summary

Introduction

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a relatively rare complication of endotracheal intubation. Little is known about the mechanisms that play a role in the development of OFTP, it is hypothesized that flawed intubation or extubation causes ischemic injury to the tracheal mucosa This ischemia may be a result of an overinflated cuff of the endotracheal tube (ETT) or hypoperfusion and accentuated by a caustic injury caused by vomiting [1]. A 31-year-old gentleman with a recent history of a motor vehicle accident was brought in by the emergency medical services accompanied by his mother due to breathing difficulty He reported that five days ago, he was involved in a motor vehicle accident, in which he sustained head trauma and underwent invasive mechanical ventilation. Vital sign parameter Temperature (F) pulse (bpm) blood pressure (mmHg) respiratory rate (per min) peripheral oxygen saturation

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