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Vol. 41. Issue 11.
Pages 638-640 (November 2005)
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Vol. 41. Issue 11.
Pages 638-640 (November 2005)
Case Reports
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Intermittent Asphyxia Syndrome Caused by a Bronchial Cast in the Subglottic Region
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J. Ferreres-Francoa,
Corresponding author
ferreres@ono.com

Correspondence: Dr. J. Ferreres-Franco. C/Tres de Abril de 1979. 46023 Valencia. España
, J. Blanquer Olivasa, E. Pastor Espláb, S. Borrás Palléa, G. Galán Gilc, A. Jordá Miñanaa
a Unidad de Cuidados Intensivos, Hospital Clínico de Valencia, Valencia, Spain
b Servicio de Neumología, Hospital San Joan, Alicante, Spain
c Servicio de Cirugía Torácica, Hospital Clínico de Valencia, Valencia, Spain
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We report the case of an intensive care unit patient with acute respiratory failure caused by severe community-acquired pneumonia with empyema. She required orotracheal intubation and mechanical ventilation. Following extubation the patient's condition improved until the onset of several choking episodes caused by a dislodged laryngotracheal cast in the subglottic region. We discuss the differential diagnosis of upper airway obstructions and of the entities related to bronchial cast formation, in particular the clinical and pathophysiological features of plastic bronchitis and the treatment options available.

Key Words:
Choking
Intermittent airway obstruction
Bronchial cast
Plastic bronchitis

Se presenta el caso de una paciente ingresada en la unidad de cuidados intensivos por insuficiencia respiratoria aguda secundaria a una neumonía comunitaria grave con empie-ma, que requirió intubación orotraqueal y ventilación mecá-nica. Tras su extubación cursó con buena evolución hasta presentar varios episodios de crisis asfícticas intermitentes secundarias a una obstrucción por el desplazamiento de un molde laringotraqueal en la zona subglótica. Se discute el diagnóstico diferencial de las obstrucciones respiratorias de la vía aérea superior, así como el de las entidades relaciona-das con la formación de moldes bronquiales, con especial atención a las bronquitis plásticas, sus características clíni-cas, fisiopatológicas y posibilidades terapéuticas.

Palabras clave:
Crisis asfíctica
Obstrucción intermitente de la vía aérea
Molde bronquial
Bronquitis plástica
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Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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