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Successful bronchoscopy in a pregnant patient with plastic bronchitis
Monali H Patil1, Attiya Siddiqi2, M Jeffrey Mador3
1University at Buffalo, Department of Pulmonary Critical Care Medicine, Buffalo, NY, USA.
Insights
Plastic bronchitis, a rare condition causing airway obstruction, can be life-threatening. This case demonstrates successful bronchoscopy with Propofol sedation in a pregnant patient, highlighting its safety in emergencies.
Area of Science:
- Pulmonology
- Cardiology
- Anesthesiology
Background:
- Plastic bronchitis involves the formation of obstructive bronchial casts, posing a critical airway emergency.
- While more common in pediatric patients post-Fontan procedure, it can occur in adults.
- Bronchoscopy during pregnancy carries risks due to potential maternal hypoxemia and fetal drug exposure.
Observation:
- A pregnant patient presented with respiratory distress due to plastic bronchitis.
- Bronchoscopy was deemed necessary despite pregnancy-related risks.
Findings:
- Successful bronchoscopy was performed using Propofol for sedation.
- This intervention effectively managed the airway obstruction.
Implications:
- Propofol-based bronchoscopy can be a safe and life-saving option for pregnant patients with plastic bronchitis.
- This case expands the understanding of managing emergent airway conditions in pregnancy.
Abstract:
Plastic bronchitis is a rare disorder, characterized by formation of thick fibrinous bronchial casts which can obstruct the airway and present as a life threatening emergency (1). It is more common in the pediatric population after corrective or palliative surgery for congenital heart disease like fontan procedure but has rarely been reported in adults as well (1). Pregnancy is a relative contraindication for bronchoscopy. Bronchoscopy in the pregnant patient poses significant risks as manipulation of the airway can lead to impaired oxygenation and ventilation. In addition, the drugs used during this procedure to provide sedation can have a direct impact on the developing fetus (2). In spite of these risks bronchoscopy should not be withheld in an emergent situation as it can be a lifesaving measure. We report a case of successful bronchoscopy using Propofol as the sedating agent in a pregnant female with plastic bronchitis who presented with respiratory distress.
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