plastic bronchitis

6 Apr

PMID: 22430124
–Do P, Randhawa I, Chin T, Parsapour K, Nussbaum E., Successful Management of Plastic Bronchitis in a Child Post Fontan: Case Report and Literature Review. Lung. 2012 Mar 20. [Epub ahead of print]

QUICK LEARNING POINTS:
Plastic bronchitis is a rare, potentially fatal, condition noted in patients after Fontan surgery.

–The mucoid impaction with cast formation occludes the major bronchi with firm, gelatinous material. 

–Acute management involves ABCs (airway, breathing, circulation), potentially requiring intubation for respiratory failure. 
–General airway clearance measures with bronchodilators and chest physiotherapy should be initiated.
–In emergent cases, immediate bronchoscopy, whether rigid or flexible, should be considered.  Bronchial casts are unique foreign bodies that may be friable or dissolvable, making lavage a necessary component of its removal.
–While bronchoscopy can be effective for acute therapy, it does not prevent recurrence nor should it be utilized on a chronic basis. 

BOTTOM LINE:
Plastic bronchitis is a rare, potentially fatal, condition noted in patients after Fontan surgery.
–treatment toolbox: inhaled mucolytics, bronchodilators, intubation & bronchoscopy if necessary

Submitted by J. Gullo.




Reference(s): article, picture

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