Mucus plugging problem in patients treated in the intensive care unit: A case report

In this paper, we will present a case who died in ICU during treatment for suicidal organophosphate intoxication. It is aimed to draw attention to the importance of regular tracheal aspiration and bronchoscopy, especially in intubated patients during treatment in ICU. In the medical documents of the case, it was learned that a 67-year-old male case was brought to a private hospital with a history of suicidal Jestis 2.5 EC, Alban EC4 (organophosphate) intake. The case died after being treated in the ICU for a total of 15 days following organophosphate intake. At autopsy, during an internal examination, approximately 5x2x1,5 cm in size, with brown-black color, organized, hardened paste consistency mucus plug was observed which was localized in the bifurcation of the trachea. It is considered to be useful to evaluate the indication of bronchoscopy in cases with better general conditions and hope for recovery.

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Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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