title: Plastic bronchitis occurring late after the Fontan procedure: treatment with aerosolized urokinase.
abstract: OBJECTIVE
  To describe the use of aerosolized urokinase in a patient with plastic bronchitis after a Fontan procedure.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Pediatric intensive care unit in a university-affiliated children's hospital.
  
  
  METHODS
  Report of one patient with acute respiratory failure secondary to plastic bronchitis.
  
  
  METHODS
  Aerosolized urokinase, multiple bronchoscopies, corticosteroids, mucolytics, bronchodilators, and atrial pacing.
  
  
  RESULTS
  Airway obstruction secondary to recurring casts improved with the treatments. Histologic analysis of the casts demonstrated less fibrin after treatments with aerosolized urokinase. No adverse events were noted.
  
  
  CONCLUSIONS
  The addition of aerosolized urokinase to this patient's treatment regimen helped to resolve life-threatening airway obstruction secondary to fibrin casts.
authors.affiliation: Department of Pediatrics, Crippled Children's Foundation Research Center, Memphis, TN 38103, USA. mquasney@utmem.edu
authors.forename: M W
authors.initials: MW
authors.lastname: Quasney
authors.forename: K
authors.initials: K
authors.lastname: Orman
authors.forename: J
authors.initials: J
authors.lastname: Thompson
authors.forename: J C
authors.initials: JC
authors.lastname: Ring
authors.forename: M
authors.initials: M
authors.lastname: Salim
authors.forename: R A
authors.initials: RA
authors.lastname: Schoumacher
authors.forename: D
authors.initials: D
authors.lastname: Watson
authors.forename: W
authors.initials: W
authors.lastname: Novick
authors.forename: S R
authors.initials: SR
authors.lastname: Deitcher
authors.forename: R
authors.initials: R
authors.lastname: Joyner
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000336:Aerosols; D001991:Bronchitis / Q000188:drug therapy* / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006801:Humans; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000209:etiology*; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D000336:Aerosols; D014568:Urokinase-Type Plasminogen Activator