Clinical study of tissue-type plasminogen activator therapy for children's plastic bronchitis / 中华实用儿科临床杂志

Objective To evaluate the clinical efficacy of tissue-type plasminogen activator (tPA) treatment of children with plastic bronchitis.Methods The study retrospectively reviewed the clinical data of the children with plastic bronchitis who were admitted to Tianjin Children's Hospital from September 2013 to January 2015 and were treated with tissue-type plasminogen activator.This study analyzed the effect and safety of tPA treatment,including clinical and radiological changes and follow-ups.Results A lot of plastic secretions were safely removed from the bronchial tubes in all children and clinical manifestations including breathing,body temperature,transcutaneous oxygen saturation and image changes were significantly improved.Conclusions Bronchoscopy is an effective way to treat plastic bronchitis,but with the use of tPA a better clinical efficacy could be achieved.The method is safe and effective and should be applied early in the patients in order to prevent the occurrence of severe airway obstruction complications.

Fatal plastic bronchitis with eosinophilic casts in a previously healthy child / 소아과

Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.

Fatal plastic bronchitis with eosinophilic casts in a previously healthy child / 소아과

Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.