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.