doi:10.1093/ejcts/ezr096 Advance Access publication 2 December 2011 Post-intubation membranous trachitis after endotracheal intubation

We read with interest the paper entitled ‘Spontaneous expec-toration of an obstructive fibrinous tracheal pseudomembrane after tracheal intubation ’ from Fiorelli et al. [1]. Membraneous trachitis is a rare complication after tracheal intubation; however, it may pose several diagnostic and therapeutic problems if mis-diagnosed. In particular, both benign tracheal strictures and simple granulation may be erroneously suspected. Direct endo-scopic observation may be difficult due either to the presence of the endotracheal tube in place, or, in the case of spontaneously breathing patients, to respiratory distress. Radiological evaluation with computed tomography (CT) may also be difficult for the same reasons. We have observed this complication in four patients during the last years. In all cases, the intubation time was less than a week long and the suspect of tracheal obstruction was raised o