Obstructive fibrinous tracheal pseudomembrane after tracheal intubation: a case report

Area of Science:

• Medical Complications
• Pulmonology
• Critical Care Medicine

Background:

• Obstructive fibrinous tracheal pseudomembrane is a rare but serious complication following endotracheal intubation.
• Previous understanding linked pseudomembrane formation to high intracuff pressure or infection.

Observation:

• This case involved a patient presenting with dyspnea and stridor post-intubation.
• The pseudomembrane formation was attributed to subglottic epithelial trauma or caustic injury from aspirated gastric contents, not tracheal ischemia from high cuff pressure.

Findings:

• Successful mechanical removal of the obstructive fibrinous tracheal pseudomembrane was achieved using rigid bronchoscopy.
• This case challenges the conventional understanding of pseudomembrane etiology.

Implications:

• Highlights the importance of considering alternative etiologies beyond high cuff pressure for tracheal pseudomembrane formation.
• Emphasizes rigid bronchoscopy as an effective treatment modality for this rare complication.
• Suggests vigilance for non-ischemic causes of tracheal pseudomembranes in intubated patients.