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Background <p>Obstructive fibrinous tracheal pseudomembrane (OFTP) is a relatively rare complication of endotracheal intubation. It can develop with short-term intubation, causing respiratory symptoms shortly after extubation. Delayed recognition of OFTP is common in clinical practice and has been reported to lead to fatal airway obstruction in some case studies. In this case report, we describe a patient of end stage renal disease (ESRD) on hemodialysis (HD) who presented with OFTP. The patient experienced cardiac arrest secondary to hyperkalemia and was intubated for 23&#xa0;h. After extubation, the patient developed symptoms from progressive dyspnea and stridor to airway obstruction, at which point, the patient was substantially re-intubated. Subsequent bronchoscopy confirmed the diagnosis of OFTP. Meanwhile, the patient’s CT scans revealed airway features correlating with the symptomatic progression.</p> Conclusion <p>Progressive dyspnea and stridor and airway abnormalities on CT scans after extubation should raise clinical considering OFTP, particularly in patients with ESRD. Fast diagnosis and treatment with bronchoscopy is crucial for enhancing patient outcomes.</p>

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Obstructive fibrinous tracheal pseudomembrane in a hemodialysis patient: a case report and review of literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月16日

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  • Jingjing Hou,
  • Haitao Li,
  • Fu Niu,
  • Xiaodan Mu,
  • Shushen Zhang,
  • Lining Huang,
  • Zhigang Cai

摘要

Background

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a relatively rare complication of endotracheal intubation. It can develop with short-term intubation, causing respiratory symptoms shortly after extubation. Delayed recognition of OFTP is common in clinical practice and has been reported to lead to fatal airway obstruction in some case studies. In this case report, we describe a patient of end stage renal disease (ESRD) on hemodialysis (HD) who presented with OFTP. The patient experienced cardiac arrest secondary to hyperkalemia and was intubated for 23 h. After extubation, the patient developed symptoms from progressive dyspnea and stridor to airway obstruction, at which point, the patient was substantially re-intubated. Subsequent bronchoscopy confirmed the diagnosis of OFTP. Meanwhile, the patient’s CT scans revealed airway features correlating with the symptomatic progression.

Conclusion

Progressive dyspnea and stridor and airway abnormalities on CT scans after extubation should raise clinical considering OFTP, particularly in patients with ESRD. Fast diagnosis and treatment with bronchoscopy is crucial for enhancing patient outcomes.