Mechanism: ischemia of the mucosa and submucosa (may be related to systemic hypotension, perinatal asphyxia, pressure necrosis from an intubation tube, and/or other cause)
Patient selection: neonate requiring ventilatory support, often with intubation
Clinical features:
(1) unexplained hypercarbia
(2) decreased chest movements
(3) evidence of airway obstruction and/or difficult to ventilate
Bronchoscopy shows a necrotic mucosa obstructing the airway. Mechanical removal of the debris restores airflow.
The diagnosis requires exclusion of a necrotizing infection affecting the large airways.
Complications may include:
(1) strictures of the airway
(2) atelectasis of lung distal to an obstructed bronchus
