Tracheobronchial Slough, a Potential Pathology in Endotracheal Tube Obstruction in Patients With Coronavirus Disease 2019 (COVID-19) in the Intensive Care Setting.

: : Treatment of the COVID-19 critically ill patient requires oxygenation and ventilation support for prolonged periods which seem unique for viral pneumonia. The pathophysiology of COVID-19 critical illness is being revealed on a day to day basis at the frontlines of care in the intensive care unit with this new disease. High density consolidations in the bronchial tree and in the pulmonary parenchyma have been described in the advanced phase of the disease. Our team has observed impeded ventilation in intubated patients who are several days into the critical course due to what seems to be tissue sloughing with resultant endotracheal tube obstruction and the consequences thereof. Caregivers need to be aware of this pathological finding, recognize, and to treat this aspect of the COVID-19 critical illness course, which is becoming more prevalent.