Acute epiglottitis in children— (An evaluation of the role of tracheotomy)

Mjeøn, S.; Dahl, T; Swensen, T.; Westheim, Arne

doi:10.1017/s0022215100088010

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Until the mid-seventies tracheostomy was the method most widely used to relieve airway obstruction in AE. Today many reports advocate nasotracheal intubation as the best method to establish an artificial airway, while some still prefer tracheostomy (Mje0n et al, 1979;Broniatowski, 1985). In a comparative study, Oh and Motoyama (1977) found no serious complications with either method, but the duration of hospitalization was significantly longer for patients treated with tracheos- tomy.…”

Section: Discussionmentioning

confidence: 99%

“…In a comparative study, Oh and Motoyama (1977) found no serious complications with either method, but the duration of hospitalization was significantly longer for patients treated with tracheos- tomy. Furthermore, tracheostomy also carries the risk of pneumothorax, bleeding, stenosis of the trachea, and a disfiguring scar (Tucker and Silberman, 1972;Mje0n et al, 1979).…”

Section: Discussionmentioning

confidence: 99%

“…The most common reason for tracheostomy, both in the Scandinavian survey and in the literature (Mje0n et al, 1979), seems to be concern about accidental extubation. In our series, seven patients were accidentally extubated.…”

Section: Discussionmentioning

confidence: 99%

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Acute epiglottitis in children and adults. Nasotracheal intubation, tracheostomy or careful observation? Current status in Scandinavia

Arndal¹,

Andreassen²

1988

J. Laryngol. Otol.

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A review was performed of the treatment of 92 patients with acute epiglottitis with special reference to the different procedures employed in children and adults. Intubation was performed in 74 per cent of the children but in only six per cent of the adults. More than half of the children were initially observed only, but of these 58 per cent eventually needed intubation. No deaths occurred. We present our management protocol as well as a survey of the routine management of acute epiglottitis in children in the five Scandinavian countries. The number of initially observed patients ranged from nil per cent in Iceland to 35 per cent in Finland. When an artificial airway is needed, 92-100 per cent of the patients are intubated, 0-8 per cent tracheostomized, and 0-5 per cent one or the other, as a standard procedure. Tracheostomy is performed in departments where the facilities do not permit sufficient observation of patients treated by intubation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute epiglottitis in children and adults. Nasotracheal intubation, tracheostomy or careful observation? Current status in Scandinavia

Arndal¹,

Andreassen²

1988

J. Laryngol. Otol.

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Acute epiglottitis in children: experiences with tracheotomy and intubation

Kinnefors

Olofsson

1983

Clin Otolaryngol

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Acute epiglottitis is one of the most serious and potentially fatal conditions dealt with in paediatric laryngology. The infectious agent is mostly Haemophilus influenzae. An active and planned treatment to secure the airway is necessary to reduce the morbidity and mortality. The ‘watch and wait’ attitude should be abandoned. Tracheotomy or intubation should be performed. Mostly literature today is in favour of intubation. However, both tracheotomy and intubation can be used, and if properly managed the complication rate with both methods is low. This series comprised 102 children of whom 79 were tracheotomized and 23 were intubated. No differences could be found between intubation or tracheotomy time (2.3 and 2.9 days respectively) or in hospital stay (6.7 and 6 days). The complication rate was low in both groups except for subcutaneous and mediastinal emphysema in the tracheotomy group but these did not cause any serious problems.

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Assessment of Intubation in Croup and Epiglottitis

Zulliger¹,

Schuller²,

Beach³

et al. 1982

Ann Otol Rhinol Laryngol

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Nasotracheal intubation for the management of airway obstruction in acute epiglottitis has become a well-received practice. However, the same technique has not received widespread support in laryngotracheobronchitis. The purpose of this study was to update the series of nasotracheal intubations in croup and epiglottitis from Columbus Children's Hospital with the specific intent to evaluate its effectiveness. All patients were evaluated for any immediate and delayed complications. Delayed complications were evaluated using parent interviews and measuring expiratory flow rates. This study of 45 children intubated for epiglottitis and 83 intubations for croup reconfirms the earlier report from this institution about its safety in both conditions. However, it has identified a subset of the croup patients who are definitely at risk to develop complications of the technique. In those children under 1 year of age, a disturbingly high incidence of subglottic stenosis was identified and this appeared to be related to the patient's age, tube size, serial intubations (dilatations), and duration of intubation. Suggested guidelines for airway management in the light of the new information are presented.

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Acute epiglottitis in children— (An evaluation of the role of tracheotomy)

Cited by 3 publications

References 9 publications

Acute epiglottitis in children and adults. Nasotracheal intubation, tracheostomy or careful observation? Current status in Scandinavia

Acute epiglottitis in children and adults. Nasotracheal intubation, tracheostomy or careful observation? Current status in Scandinavia

Acute epiglottitis in children: experiences with tracheotomy and intubation

Assessment of Intubation in Croup and Epiglottitis

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