CASE REPORTS
JOURNAL ARTICLE
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The use of high-frequency jet ventilation for removal of obstructing casts in patients with plastic bronchitis.

OBJECTIVE: To describe improved cast removal with short periods of high-frequency jet ventilation (HFJV) in patients with single ventricle physiology.

DESIGN: Case report.

SETTING: Pediatric cardiac intensive care unit.

PATIENTS: Two patients with plastic bronchitis during prolonged stay in a intensive care unit after a Fontan-type operation.

INTERVENTIONS: Short periods of HFJV.

MAIN RESULTS: Plastic bronchitis with lower airway obstruction developed in two intubated patients during intensive care stay after the Fontan operation. Mucolytics and suctioning were not effective in controlling symptoms. Urgent bronchoscopy was considered a high-risk procedure for the first patient and was not available for the second. Cast removal was achieved with short periods of HFJV and subsequent suctioning.

CONCLUSIONS: The use of short-term HFJV resulted in resolution of the airway obstruction in intubated patients with plastic bronchitis.

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