FIGURE LEGEND:
Figure 1. Chest radiographs, clinical metrics, and bronchoscopic
images after cinnamon aspiration. Radiographs were taken (A) on
hospital day 1 at approximately 12 hours after admission, (B) on
hospital day 6 after deployment of ECMO, and (C) on outpatient follow-up
approximately 6 months after admission. (A) The radiologist’s
interpretation included findings of hyperexpanded lungs with patchy
right lower and left retrocardiac opacities, with a possible small left
pleural effusion. (B) At the time of ECMO initiation, the radiograph
revealed evolution of the bilateral lower lobe opacities,
pneumomediastinum, and pneumopericardium; no pneumothorax was present at
this time. (C) Upon outpatient follow-up, the radiologist reported
findings of persistent patchy opacities in the right lower lobe, with
resolution of any obvious radio-opaque findings on the left. Of note, an
incidental finding of a left anterior six rib contour abnormality was
also noted on all films. In (D), the patient’s oxygenation index (OI),
pCO2, and minute ventilation are depicted over the
period during which the patient was invasively ventilated. The duration
of venovenous extracorporeal membrane oxygenation (VV-ECMO) is shaded in
pink. The vertical dotted lines indicate days of three bronchoscopies.
Attained on HD 9 (E), bronchoscopic images demonstrate occlusion of the
airways with brown debris and significant mucosal erythema.