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Obstructive fibrinous pseudomembrane tracheitis after double-lumen tube intubation -a case report

Jia-Hui Chua1, Brenda Ling Hui Sim2, Tina Koh Puay Theng3

  • 1Division of Anesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore.

Korean Journal of Anesthesiology
|February 22, 2022
PubMed
Abstract

Insights

Obstructive fibrinous pseudomembrane tracheitis (OFPT) is a rare but serious complication following endotracheal intubation. Early diagnosis and intervention, such as laryngoscopy, are crucial for managing this life-threatening airway obstruction.

Area of Science:

  • Medicine
  • Pulmonology
  • Critical Care

Background:

  • Obstructive fibrinous pseudomembrane tracheitis (OFPT) is a rare complication associated with endotracheal intubation.
  • This condition can lead to acute, life-threatening airway obstruction.

Observation:

  • A case is presented of a 73-year-old woman who developed severe stridor two days post-extubation after short-term intubation for surgery.
  • The patient required an emergency tracheostomy to secure the airway.

Findings:

  • Microscopic direct laryngoscopy successfully removed the obstructive pseudomembrane.
  • Histological examination confirmed mucosal ulcerations and inflammatory changes consistent with OFPT.
  • The patient also experienced a non-ST-elevation myocardial infarction but recovered fully.

Implications:

  • OFPT is an underrecognized cause of post-extubation airway emergencies.
  • Early bronchoscopic intervention or microscopic direct laryngoscopy are effective treatment modalities.
  • Prompt management is vital for patient recovery and preventing fatal airway compromise.
Keywords:
Airway managementAirway obstructionRespiratory insufficiencyRespiratory tract diseasesTracheal stenosisTracheitis

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