Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-23T00:49:19.843Z Has data issue: false hasContentIssue false
  • English
  • Français

Aerosolised heparin in the treatment of Fontan-related plastic bronchitis

Published online by Cambridge University Press:  18 January 2013

Daniel E. Eason ,
Kristin Cox  and
William B. Moskowitz
Daniel E. Eason*
Affiliation:
Division of Pediatric Cardiology, Miller School of Medicine, University of Miami, Miami, Florida
Kristin Cox
Affiliation:
Department of Pediatrics, Clinical Pharmacy, Richmond, Virginia, United States of America
William B. Moskowitz
Affiliation:
Division of Pediatric Cardiology, Children's Hospital of Richmond at VCU Medical Center, Richmond, Virginia, United States of America
*
Correspondence to: Dr D. E. Eason, DO, MPH, Division of Pediatric Cardiology, Miller School of Medicine, University of Miami, PO Box 016960 (R-76), Miami, FL 33101, United States of America. Tel: +1 919 210 2184; Fax: +1 866 823 6013; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Patients with Fontan palliation and single-ventricle physiology encounter multiple comorbidities including plastic bronchitis, a disease characterised by the plugging of small and large airways by rubbery, white casts. To date, no controlled clinical trials have demonstrated effective treatment of plastic bronchitis. We report the application of aerosolised heparin, which has published success in non-cardiac-related pulmonary disease, for this complication in a Fontan patient.

Keywords

Single ventricletricuspid atresiabronchial castburn inhalational injury
Type
Brief Reports
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 140 - 142
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Goo, HW, Jhang, W, Kim, Y, et al. CT findings of plastic bronchitis in children after a Fontan operation. Pediatr Radiol 2008; 38: 989–993.Google Scholar
2. Goldberg, DJ, Shaddy, RE, Ravishankar, C, Rychik, J. The failing Fontan: etiology, diagnosis and management. Expert Rev Cardiovasc Ther 2011; 9: 785–793.Google Scholar
3. Seear, M, Hui, H, Magee, F, et al. Bronchial casts in children: a proposed classification based on nine cases and a review of the literature. Am J Respir Crit Care Med 1997; 155: 364–370.CrossRefGoogle Scholar
4. Brogan, TV, Finn, LS, Pyskaty, DJ, et al. Plastic bronchitis in children: a case series and review of the medical literature. Pediatr Pulmonol 2002; 34: 482–487.Google Scholar
5. Madsen, P, Shah, SA, Rubin, BK. Plastic bronchitis: new insights and a classification scheme. Paediatr Respir Rev 2005; 6: 292–300.CrossRefGoogle Scholar
6. Barber, BJ, Burch, GH, Tripple, D, Balaji, S. Resolution of plastic bronchitis with atrial pacing in a patient with Fontan physiology. Pediatr Cardiol 2004; 25: 73–76.Google Scholar
7. Yalcin, E, Özçelik, U, Celiker, A. Plastic bronchitis occurring late after the Fontan procedure in a child: treatment with stent implantation in the left pulmonary artery. J Invasive Cardiol 2005; 17: 326–328.Google Scholar
8. Shah, SS, Drinkwater, DC, Christian, KG. Plastic bronchitis: is thoracic duct ligation a real surgical option? Ann Thorac Surg 2006; 81: 2281–2283.CrossRefGoogle ScholarPubMed
9. Zahorec, M, Kovacikova, L, Martanovic, P, et al. The use of high-frequency jet ventilation for removal of obstructing casts in patients with plastic bronchitis. Pediatr Crit Care Med 2009; 10: e34–e36.Google Scholar
10. Do, T, Chu, J, Berdjis, F. Fontan patient with plastic bronchitis treated successfully using aerosolized tissue plasminogen activator: a case report and review of the literature. Pediatr Cardiol 2009; 30: 352–355.Google Scholar
11. Kovesi, T, Gardin, L. Bronchial cast. Pediatr Cardiol 2012; 33: 675–676.CrossRefGoogle ScholarPubMed
12. Desai, M, Mlcak, R, Richardson, J, Nichols, R, Herndon, N. Reduction in mortality in pediatric patients with inhalation injury with aerosolized heparin/acetylcystine therapy. J Burn Care Rehab 1998; 19: 210–212.Google Scholar
13. Miller, A, Rivero, A, Ziad, S, Smith, D, Elamin, E. Influence of nebulized unfractionated heparin and n-acetylcysteine in acute lung injury after smoke inhalation injury. J Burn Care Res 2009; 30: 249–256.Google Scholar
14. Li, Q, Lei, RX, Zhou, XD, et al. Regulation of PMA-induced MUC5AC expression by heparin in human bronchial epithelial cells. Mol Cell Biochem 2012; 360: 383–391.Google Scholar