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

作者：Jingjing Hou, Haitao Li, Fu Niu, Xiaodan Mu, Shushen Zhang, Lining Huang, Zhigang Cai · 发表于：BMC Nephrology · 年份：2025 · DOI：10.1186/s12882-025-04704-0 · 研究领域：Tracheal and airway disorders、Nosocomial Infections in ICU、Otolaryngology and Infectious Diseases

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.