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Obstructive Fibrinous Tracheal Pseudomembrane

Yoann Ammar1, Juliette Vella-Boucaud, Claire Launois

  • 1From the Department of Respiratory Diseases, University Hospital, Reims, France.

Anesthesia and Analgesia
|June 4, 2016
PubMed

Insights

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a rare complication after endotracheal intubation. Early recognition and bronchoscopic removal are crucial for effective treatment and preventing recurrence.

Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Otolaryngology

Background:

  • Obstructive fibrinous tracheal pseudomembrane (OFTP) is a rare but severe complication following endotracheal intubation.
  • It presents as a tubular pseudomembrane obstructing the trachea, leading to airway obstruction symptoms post-extubation.

Purpose of the Study:

  • To review and summarize all published cases of OFTP.
  • To analyze the clinical presentation, diagnosis, and treatment outcomes of OFTP.

Main Methods:

  • Systematic review of published literature on OFTP cases from 1981 to 2015.
  • Analysis of patient demographics, intubation details, symptom onset, severity of obstruction, and treatment interventions.

Main Results:

  • 58 cases of OFTP were identified. The mean age was 36 ± 22 years, with 23/52 males. Emergent intubation was common (41/53 cases).
  • Symptoms appeared 3 ± 3 days post-extubation, with 19/39 cases presenting acutely. Significant tracheal obstruction (≥70%) was noted in 14/18 cases. Acute respiratory failure occurred in 13/39 cases.
  • Bronchoscopic removal was performed in 49/58 cases, with no reported recurrences.

Conclusions:

  • OFTP has a characteristic clinical and endoscopic presentation.
  • Early recognition and bronchoscopic intervention are vital for successful diagnosis and treatment, with no recurrence observed after this procedure.

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