Obstructive Fibrinous Tracheal Pseudomembrane: An Uncommon Presentation

Education| January 2025 Obstructive Fibrinous Tracheal Pseudomembrane: An Uncommon Presentation Kazufumi Yaginuma, M.D.; Kazufumi Yaginuma, M.D. 1Department of Pediatrics, Fukushima Medical University, Fukushima, Japan; Department of Pediatric Anesthesiology and Intensive Care Medicine, Jichi Children's Medical Center Tochigi, Tochigi, Japan. https://orcid.org/0000-0001-8238-6039 Search for other works by this author on: This Site PubMed Google Scholar Masahiro Watanabe, M.D., Ph.D.; Masahiro Watanabe, M.D., Ph.D. 2Department of Pediatrics, Fukushima Medical University, Fukushima, Japan. Search for other works by this author on: This Site PubMed Google Scholar Yasushi Saito, M.D.; Yasushi Saito, M.D. 3Department of Pediatrics, Fukushima Medical University, Fukushima, Japan. Search for other works by this author on: This Site PubMed Google Scholar Mitsuaki Hosoya, M.D., Ph.D. Mitsuaki Hosoya, M.D., Ph.D. 4Department of Pediatrics, Fukushima Medical University, Fukushima, Japan. Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal's Web site (). Address correspondence to Dr. Yaginuma: ; kazyaginuma@gmail.com Anesthesiology January 2025, Vol. 142, 178–179. https://doi.org/10.1097/ALN.0000000000005242 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Kazufumi Yaginuma, Masahiro Watanabe, Yasushi Saito, Mitsuaki Hosoya; Obstructive Fibrinous Tracheal Pseudomembrane: An Uncommon Presentation. Anesthesiology 2025; 142:178–179 doi: https://doi.org/10.1097/ALN.0000000000005242 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: pseudomembrane, trachea Obstructive fibrinous tracheal pseudomembrane is characterized by pathological membranes forming along the tracheal inner walls, potentially leading to airway obstruction.1 These pseudomembranes, composed of fibrous tissues, form due to mechanical stimuli from endotracheal tube (ETT) management.2 Figures and video clips were obtained from a 6-yr-old male child experiencing influenza A virus and pneumonia. He was initially intubated at a previous hospital with a 5.5 mm cuffed ETT. Due to the absence of a cuff leak, it was replaced with a 5.0 mm cuffed ETT. After endotracheal suctioning, he exhibited sudden respiratory failure, hypoxemia, bradycardia, and hypotension, necessitating resuscitation secondary to ETT occlusion from the pseudomembrane. Bronchoscopic examination identified a tracheal pseudomembrane that facilitated airway opening during inspiration but obstructed it during expiration distal to the ETT (fig. 1, A and B, and Supplemental Digital Content, https://links.lww.com/ALN/D693). The blue line indicates the direction of the... You do not currently have access to this content.