Food for Thought: Dietary Intervention in a Rare Cause of Severe Ventilatory Failure

  • Henry Yung Respiratory Department, Cambridge University Hospitals, Cambridge, UK; Rayne Institute, University College London, London, UK
  • Keshav Sharma Respiratory Department, Cambridge University Hospitals, Cambridge, UK
  • William Flowers Respiratory Department, Cambridge University Hospitals, Cambridge, UK
  • Malcolm Marquette Respiratory Department, Cambridge University Hospitals, Cambridge, UK
  • Laura Starace Nutrition and Dietetics Team, Cambridge University Hospitals, Cambridge, UK
  • Clare Sander Respiratory Department, Cambridge University Hospitals, Cambridge, UK
  • Rowan Burnstein Neurocritical Care Unit, Cambridge University Hospitals, Cambridge, UK
  • Jurgen Herre Respiratory Department, Cambridge University Hospitals, Cambridge, UK

Keywords

Plastic bronchitis, bronchial casts, extracorporeal membrane oxygenation, asthma, mechanical ventilation

Abstract

Plastic bronchitis is a rare condition characterised by endobronchial cast formation. We report the case of a 53-year-old women who deteriorated following an elective bronchoscopy procedure. She developed refractory ventilatory failure and required repeated bronchoscopy, which identified thick tenacious casts as the cause of her airway compromise. She did not respond to conventional therapies including endoscopic clearance, mucolytic therapy and nebulised tissue plasminogen activator (TPA). Total parenteral nutrition and a fat-free enteral diet were instituted while the patient was on extracorporeal membrane oxygenation (ECMO), which led to substantial improvement in her condition and demonstrated the importance of dietary strategies in this case.

VIEW THE ENTIRE ARTICLE

References

  • Cavric G, Naumovski-Mihalic S, Kardum-Skelin I, et al. [Acute plastic bronchitis--case report]. Acta Med Croatica 2011;65(Suppl 1):127–131.

  • Turgut T, In E, Ozercan IH, et al. A case of plastic bronchitis. Arch Iran Med 2014;17(8):589–590.

  • Itkin M. Interventional treatment of pulmonary lymphatic anomalies. Tech Vasc Interv Radiol 2016;19(4):299–304.

  • Shah A, Donovan J, Marino P, et al. A lesson in plasticity: a 74-year-old man with plastic bronchitis. Thorax 2017;72(11):1055-1057.

  • Guevara CJ, Rialon KL, Ramaswamy RS, et al. US-guided, direct puncture retrograde thoracic duct access, lymphangiography, and embolization: feasibility and efficacy. J Vasc Interv Radiol 2016;27(12):1890–1896.
  • Published: 2020-03-26

    Issue: Vol 7 No 5 (view)

    Section: Articles

    How to cite:
    Yung, H., Sharma, K., Flowers, W., Marquette, M., Starace, L., Sander, C., Burnstein, R., & Herre, J. (2020). Food for Thought: Dietary Intervention in a Rare Cause of Severe Ventilatory Failure. European Journal of Case Reports in Internal Medicine, 7(5). https://doi.org/https://doi.org/10.12890/2020_001523