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Chronic Respiratory Disease
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What's this?

research-article

A fatal case of airway obstruction by an organic one-way valve

F Bresci

Department of Neurosciences, Institute of Legal Medicine, University of Pisa, Pisa, Italy

M Di Paolo

Department of Neurosciences, Institute of Legal Medicine, University of Pisa, Pisa, Italy

M Martelli

Intensive Care Unit, Department of Surgery, University Hospital, Pisa, Italy

L De Simone

Intensive Care Unit, Department of Surgery, University Hospital, Pisa, Italy

F Giunta

Intensive Care Unit, Department of Surgery, University Hospital, Pisa, Italy

N Ambrosino

Pulmonary Unit, Cardio-Thoracic Department, University Hospital, Pisa, Italy n.ambrosino{at}ao-pisa.toscana.it

We report a fatal case of airway obstruction. A tracheostomized, spontaneously breathing 39-year-old man developed dyspnea, cardiac, and respiratory arrest after tracheal cannula replacement. Inspection of the cannula showed a blood clot obstructing the tube. Autopsy showed pink foam in the trachea, pulmonary hyperinflation, and congested lung parenchyma. Histological examination showed acute pulmonary emphysema without any sign of blood inhalation. The probable pathophysiological mechanism is a clot creating a one-way valve allowing inspiration but not expiration, resulting in dyspnea and pulmonary hyperinflation.

Key Words: tracheal blood clot • tracheal cannula obstruction • tracheostomy • ventilator assisted individuals

Chronic Respiratory Disease, Vol. 6, No. 1, 47-48 (2009)
DOI: 10.1177/1479972308098667
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