Site involvement as a predictor of airway intervention in angioedema

Abstract

Site of involvement was found to correlate with airway intervention. Involvement of anterior tongue, BOT, and larynx significantly increased the likelihood of intubation or tracheostomy, as did involvement of multiple sites. Thorough evaluation, including fiberoptic laryngoscopy, can aid in determining which patients require airway intervention.

Antihypertensive drug-induced angioedema causing upper airway obstruction in children

“…They also found that the higher number of airway sites involved, the more likely intervention was needed. This finding was especially evident when the larynx or base of the tongue was involved [8]. For difficult intubation cases, an emergent cricothyroidotomy or a tracheotomy may be required.…”

“…Early intubation may be required depending on the severity and site of the edema. An adult study by McCormick et al [8] states that patients with involvement of the anterior tongue, larynx, or the base of tongue were significantly more likely to require airway intervention. They also found that the higher number of airway sites involved, the more likely intervention was needed.…”

“…Patients with anterior tongue edema should have a flexible laryngoscope exam to evaluate for edema at the posterior tongue, supraglottis, and larynx [8].…”

“…result from the leakage of fluid into the interstitial space due to mast cell-derived vasoactive mediators, histamine and proteases, with bradykinin playing a major role [8]. As the course of angioedema can be unpredictable and may progress rapidly, it is essential for clinicians to promptly recognize is symptoms and institute treatment to avoid potential life-threatening upper airway obstruction.…”

Angiotensin-converting enzyme inhibitors induced angioedema: the hardest is thinking about it!

“…Le traitement était inefficace. L'oedème continuait à progresser avec une protrusion linguale importante et une extension dans les zones paracervicales droites, motivant ainsi son admission en service de réanimation dans la crainte d'une extension laryngée avec signes prédictifs d'intubation difficile [5]. Le diagnostic d'angioedème bradykinique était alors suspecté devant les caractéristiques cliniques évocatrices, la localisation particulière aux muqueuses de la face et la protrusion linguale caractéristique, et dont l'origine était compatible avec la prise chronique d'IEC.…”