title: Casting a look at pediatric plastic bronchitis.
abstract: OBJECTIVE
  To review clinical presentations and management strategies for children with plastic bronchitis.
  
  
  METHODS
  Retrospective chart review.
  
  
  RESULTS
  Seven patients required rigid bronchoscopy to remove bronchial casts over a 17-year study period. Mean age at presentation was 60 months. Mean follow-up was 53 months. Co-morbidities included: congenital heart disease (n=3), chronic pulmonary disorders (n=2) and sickle cell disease (n=1). 4 patients required multiple bronchoscopies for recurrent casts. Adjunctive topical therapies were administered in all 7 patients, without complication. Rigid bronchoscopy for cast removal was performed in 2 patients who were on extra-corporal membrane oxygenation (ECMO), using special precautions to safeguard the ECMO catheters.
  
  
  CONCLUSIONS
  Bronchial casts in children may present acutely or sub-acutely. Recurrent casts are unusual; however, in combination with severe cardiac disease may lead to mortality. Adjunctive topical therapies are still under investigation. Special safeguards for ECMO catheters are imperative. This case series complements and adds to the International Plastic Bronchitis Registry.
authors.affiliation: Division of Pediatric Otolaryngology, British Columbia's Children's Hospital, Vancouver, BC, Canada. Electronic address: t.jasinovic@gmail.com.
authors.forename: Tin
authors.initials: T
authors.lastname: Jasinovic
authors.affiliation: Division of Pediatric Otolaryngology, British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: Frederick K
authors.initials: FK
authors.lastname: Kozak
authors.affiliation: Division of Pediatric Otolaryngology, British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: J Paul
authors.initials: JP
authors.lastname: Moxham
authors.affiliation: Division of Pediatric Respirology, British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Chilvers
authors.affiliation: Division of Pediatric Respirology, British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Wensley
authors.affiliation: Division of Pediatric Respirology, British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Seear
authors.affiliation: Division of Pediatric Cardiac Surgery, British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Campbell
authors.affiliation: Division of Pediatric Otolaryngology, British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Ludemann
mesh_terms: D001991:Bronchitis / Q000628:therapy*; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013165:Splints / Q000009:adverse effects*
keywords: Bronchial casts; ECMO; Plastic bronchitis; Rigid bronchoscopy