Successful tracheostomy tube removal following airway clearance using intrapulmonary percussive ventilation treatment after bilateral lung transplantation in a patient with idiopathic pleuroparenchymal fibroelastosis

Sputum management is a critical and potentially lethal issue in patients following lung transplantation. Here, we describe a patient with idiopathic pleuroparenchymal fibroelastosis who underwent tracheotomy after deceased donor bilateral lung transplantation, in whom we were unable to remove the tracheostomy tube due to difficulty in sputum evacuation. The tube was successfully removed following the subsequent initiation of intrapulmonary percussive ventilation (IPV) treatment combined with pulmonary rehabilitation. IPV has been widely used for several decades for treating pulmonary conditions, including chronic obstructive pulmonary disease, cystic fibrosis, and bronchiectasis. However, it should also be considered for airway clearance after lung transplantation.