Plastic bronchitis occurring late after the Fontan procedure: treatment with aerosolized urokinase.
Objective: To describe the use of aerosolized urokinase in a patient with plastic bronchitis after a Fontan procedure.
Methods: Case report. Methods: Pediatric intensive care unit in a university-affiliated children's hospital. Methods: Report of one patient with acute respiratory failure secondary to plastic bronchitis. Methods: Aerosolized urokinase, multiple bronchoscopies, corticosteroids, mucolytics, bronchodilators, and atrial pacing.
Results: Airway obstruction secondary to recurring casts improved with the treatments. Histologic analysis of the casts demonstrated less fibrin after treatments with aerosolized urokinase. No adverse events were noted.
Conclusions: The addition of aerosolized urokinase to this patient's treatment regimen helped to resolve life-threatening airway obstruction secondary to fibrin casts.