BACKGROUND Plastic bronchitis (PB) is a complication of Fontan surgery, results in the formation of mucus plug in the tracheobronchial tree, causing potentially fatal airway obstruction. We report critical airway emergency during general anesthesia in a child with plastic bronchitis. CASE PRESENTATION A 5-year-old boy was scheduled for intrapulmonary lymphatic embolization through percutaneous catheterization under general anesthesia. He underwent Fontan surgery at the age of 2 and frequently developed respiratory failure due to plastic bronchitis. After induction of general anesthesia and tracheal intubation, mechanical ventilation became difficult even with an inspiratory pressure ≥ 50 mmHg due to airway obstruction. He expectorated a large mucus plug through the tracheal tube after administration of sugammadex, naloxone, and flumazenil, and respiratory condition was stabilized thereafter. CONCLUSION General anesthesia for a patient with plastic bronchitis should be planned with extracorporeal membrane oxygenation or cardiopulmonary bypass stand by.
CITATION STYLE
Nakamoto, H., Kayama, S., Harada, M., Honjo, T., Kubota, K., & Sawamura, S. (2020). Airway emergency during general anesthesia in a child with plastic bronchitis following Fontan surgery: a case report. JA Clinical Reports, 6(1). https://doi.org/10.1186/s40981-020-0311-5
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