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Intern Med. 2017 Sep 15. doi: 10.2169/internalmedicine.8137-16. [Epub ahead of print]
Bloody Bronchial Cast Formation Due to Alveolar Hemorrhage Associated with H1N1 Influenza Infection.
Okada Y1, Okada A1, Narumiya H1, Iiduka R1, Katsura K2.
Author information
Abstract
A previously healthy 55-year-old man with H1N1 influenza A presented with severe respiratory failure and cardiac arrest. Following the return of spontaneous circulation, venovenous extracorporeal membrane oxygenation was required to maintain oxygenation. On day 2, bronchoscopy revealed a bloody bronchial cast obstructing the right main bronchus. A pathological examination revealed that it was composed of intrabronchial and intra-alveolar hemorrhagic tissue. Unfortunately, the patient died due to severe brain ischemia; a subsequent autopsy revealed marked alveolar hemorrhage. It is possible that anticoagulant therapy, alveolar collapse, and neuromuscular blocking agents provoked cast development in this case.
KEYWORDS:
ECMO; alveolar collapse; anticoagulation; complication; plastic bronchitis; white out
PMID: 28924110 DOI: 10.2169/internalmedicine.8137-16
Bloody Bronchial Cast Formation Due to Alveolar Hemorrhage Associated with H1N1 Influenza Infection.
Okada Y1, Okada A1, Narumiya H1, Iiduka R1, Katsura K2.
Author information
Abstract
A previously healthy 55-year-old man with H1N1 influenza A presented with severe respiratory failure and cardiac arrest. Following the return of spontaneous circulation, venovenous extracorporeal membrane oxygenation was required to maintain oxygenation. On day 2, bronchoscopy revealed a bloody bronchial cast obstructing the right main bronchus. A pathological examination revealed that it was composed of intrabronchial and intra-alveolar hemorrhagic tissue. Unfortunately, the patient died due to severe brain ischemia; a subsequent autopsy revealed marked alveolar hemorrhage. It is possible that anticoagulant therapy, alveolar collapse, and neuromuscular blocking agents provoked cast development in this case.
KEYWORDS:
ECMO; alveolar collapse; anticoagulation; complication; plastic bronchitis; white out
PMID: 28924110 DOI: 10.2169/internalmedicine.8137-16