title: Obstructive Fibrinous Tracheal Pseudomembrane After Endotracheal Intubation.
abstract: Obstructive fibrinous tracheal pseudomembrane (OFTP) is an uncommon complication that results after tracheal intubation. Herein, we perform a systematic review of the PubMed and EmBase databases for all the cases describing OFTP. The systematic search yielded 28 citations describing 53 subjects with OFTP. The study population (61.1% females) comprised of both adults and pediatric subjects with a median (IQR) age of 40.5 (14.8-60.5) years. The median (IQR) size of endotracheal tube was 7.5 (6-9.3) mm with a median (IQR) duration of intubation of 36 (14-96) hours. The median (IQR) time to onset of symptoms after extubation was 24 (6-96) hours. Stridor was the most common symptom. The average delay in correctly identifying the OFTP was 26 hours. The diagnosis of tracheal pseudomembrane was confirmed by flexible bronchoscopy in 38 (70.4%) instances while rigid bronchoscopy was used in 46.3% subjects for removing the pseudomembrane. There were two deaths, one each in an adult and a pediatric subject. OFTP is a complication of tracheal intubation and presents with respiratory failure. The diagnosis can be confirmed by flexible bronchoscopy. Treatment involves removal of the obstructing membrane with either flexible or rigid bronchoscopy.
authors.affiliation: Department of Pulmonary Medicine.
authors.forename: Inderpaul Singh
authors.initials: IS
authors.lastname: Sehgal
authors.affiliation: Department of Pulmonary Medicine.
authors.forename: Sahajal
authors.initials: S
authors.lastname: Dhooria
authors.affiliation: Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amanjit
authors.initials: A
authors.lastname: Bal
authors.affiliation: Department of Pulmonary Medicine.
authors.forename: Ashutosh N
authors.initials: AN
authors.lastname: Aggarwal
authors.affiliation: Department of Pulmonary Medicine.
authors.forename: Digambar
authors.initials: D
authors.lastname: Behera
authors.affiliation: Department of Pulmonary Medicine agarwal.ritesh@outlook.in.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Agarwal
mesh_terms: D060666:Airway Extubation / Q000009:adverse effects; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D001999:Bronchoscopy; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D012135:Respiratory Sounds / Q000209:etiology; D014133:Tracheal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy
keywords: endotracheal intubation; post intubation stenosis; rigid bronchoscopy; tracheal membrane; tracheal pseudomembrane; upper airway obstruction