title: A fatal case of airway obstruction by an organic one-way valve.
abstract: We report a fatal case of airway obstruction. A tracheostomized, spontaneously breathing 39-year-old man developed dyspnea, cardiac, and respiratory arrest after tracheal cannula replacement. Inspection of the cannula showed a blood clot obstructing the tube. Autopsy showed pink foam in the trachea, pulmonary hyperinflation, and congested lung parenchyma. Histological examination showed acute pulmonary emphysema without any sign of blood inhalation. The probable pathophysiological mechanism is a clot creating a one-way valve allowing inspiration but not expiration, resulting in dyspnea and pulmonary hyperinflation.
authors.affiliation: Department of Neurosciences, Institute of Legal Medicine, University of Pisa, and Intensive Care Unit, Department of Surgery, University Hospital, Pisa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bresci
authors.forename: M
authors.initials: M
authors.lastname: Di Paolo
authors.forename: M
authors.initials: M
authors.lastname: Martelli
authors.forename: L
authors.initials: L
authors.lastname: De Simone
authors.forename: F
authors.initials: F
authors.lastname: Giunta
authors.forename: N
authors.initials: N
authors.lastname: Ambrosino
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male