Pediatric Acute Respiratory Distress Syndrome and Tracheal Injury in a Patient Requiring Extracorporeal Membrane Oxygenation Following Cement Aspiration: A Case Report

Madeleine Böhrer, MD, FRCPC; Cai Long, MD; Adrienne Thompson, MD, FRCPC, DABR; Stasa Veroukis, MD, FRCPC; Gurpreet Khaira, MD, FRCPC

doi:10.1097/CCE.0000000000000969

Critical Care Explorations (Sep 2023)

Pediatric Acute Respiratory Distress Syndrome and Tracheal Injury in a Patient Requiring Extracorporeal Membrane Oxygenation Following Cement Aspiration: A Case Report

Madeleine Böhrer, MD, FRCPC,
Cai Long, MD,
Adrienne Thompson, MD, FRCPC, DABR,
Stasa Veroukis, MD, FRCPC,
Gurpreet Khaira, MD, FRCPC

Affiliations

Madeleine Böhrer, MD, FRCPC: 1 Division of Critical Care Medicine, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada.
Cai Long, MD: 2 Division of Otolaryngology, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Adrienne Thompson, MD, FRCPC, DABR: 3 Department of Pediatric Radiology, Department of Diagnostic Radiology, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada.
Stasa Veroukis, MD, FRCPC: 4 Department of Pediatric Critical Care Medicine, The Children’s Hospital of Winnipeg, University of Manitoba, Winnipeg, Manitoba, Canada.
Gurpreet Khaira, MD, FRCPC: 1 Division of Critical Care Medicine, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada.

DOI: https://doi.org/10.1097/CCE.0000000000000969
Journal volume & issue: Vol. 5, no. 9
p. e0969

Abstract

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BACKGROUND:. Ingestion and aspiration of caustic substances is a common problem in pediatrics and carries the risk of associated aspiration pneumonitis, laryngeal injury, and esophageal injury. Extracorporeal membrane oxygenation (ECMO) has been used to support adults with acute respiratory distress syndrome (ARDS) from aspiration of cement dust, however, literature outlining pediatric management in cases of alkali lung and airway injuries is lacking. CASE SUMMARY:. A 6-year-old boy presented with ARDS from cement aspiration requiring high-pressure ventilation. He had further complications of tracheal injury with subsequent pneumomediastinum secondary to the alkali burn. He required ECMO to facilitate repeat bronchoscopy for cement particle washout and to enable recovery from ARDS and tracheal injury. CONCLUSION:. This case highlights the need to perform early bronchoscopy and gastrointestinal endoscopy for injury assessment and foreign body removal in alkali burns. It also emphasizes the value of ECMO support for respiratory failure and facilitating bronchoalveolar lavage when it is not otherwise tolerated.

Published in Critical Care Explorations

ISSN: 2639-8028 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://journals.lww.com/ccejournal/pages/default.aspx

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