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Plastic bronchitis occurring late after the Fontan procedure: treatment with aerosolized urokinase
M W Quasney1, K Orman, J Thompson
1Department of Pediatrics, Crippled Children's Foundation Research Center, Memphis, TN 38103, USA. mquasney@utmem.edu
Objective:
To describe the use of aerosolized urokinase in a patient with plastic bronchitis after a Fontan procedure.
Design:
Case report.
Setting:
Pediatric intensive care unit in a university-affiliated children's hospital.
Patients:
Report of one patient with acute respiratory failure secondary to plastic bronchitis.
Interventions:
Aerosolized urokinase, multiple bronchoscopies, corticosteroids, mucolytics, bronchodilators, and atrial pacing.
Measurements And Main Results:
Airway obstruction secondary to recurring casts improved with the treatments. Histologic analysis of the casts demonstrated less fibrin after treatments with aerosolized urokinase. No adverse events were noted.
Conclusions:
The addition of aerosolized urokinase to this patient's treatment regimen helped to resolve life-threatening airway obstruction secondary to fibrin casts.