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Airway management in acute infectious croup syndromes

Abstract

The article presents the author’s experience with airway management of 500 children with acute infectious croup and epiglottitis over a 7-year period in a teaching hospital setup. A policy of early elective protective intubation under controlled condition for children with severe croup and epiglottitis, in a multidisciplinary intensive care setting resulted in a satisfactory outcome. Recent developments in the field are discussed; these include non-invasive monitoring, medical treatment options for viral croup with parenteral high dose dexamethasone and nebulized adrenaline, newer broad-spectrum antimicrobials for drug-resistant bacterial infectious and an effective vaccine against Hemophilus influenzae type b. These hold the promise of reducing morbidity and mortality from acute infectious croup syndromes even in situations with limited surgical and monitoring facilities.

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References

  1. 1.

    Silverman BK, (1993): Respiratory distress. In Silverman BK, ed. APLS: The Pediatric Emergency Medicine Course, 2nd ed. AAP/ACEP, USA, pp 3–17.

  2. 2.

    Cote CJ, Todres ID, (1993): The pediatric airway. In Cote CJ, Ryan JF, Todres ID, Croudsouzian NC,eds. A Practice of Anesthesia for Infants and Children. 2nd ed. Philadelphia, Pa: WB Saunders.

  3. 3.

    Chameides L, Hazinski MF, (1994): Pediatric basic life support. In Pediatric Advanced Life Support. American Heart Association, USA.

  4. 4.

    Auchterlonie IA, Benjamin B. (1985): Neck radiographs in croup syndrome. Letter: Arch Dis Child 60: 288.

  5. 5.

    Kairys SW, Olmstead EM. (1989): Steroid treatment of laryngotracheitis; a meta-analysis of the evidence from randomized trials. Pediatrics, 83: 683–693.

  6. 6.

    Cruz MN, Stewart C, Rosenberg N. (1995): Use of dexamethasone in the outpatient management of acute laryngotracheitis. Pediatrics 96: 220–223.

  7. 7.

    Freezer N, Butt W, Phelan P. (1990): Steroids in croup: do they increase the incidence of successful extubation? Anesth Intens Care 18: 224–226.

  8. 8.

    Waisman Y, Klein BL, Boenning DA etal. (1992): Prospective randomized double-blind study comparing L-epinephrine and racemic epinephrine aerosols in the treatment of laryngotracheitis (croup). Pediatrics 89: 302–306.

  9. 9.

    Hinton W, Coss IJ, (1987): Croup, nebulized adrenaline and preservatives. Anesthesia 42: 436–437.

  10. 10.

    Jonsdottir KE. (1992): Immunisation of infants in Iceland against Haemophilus influenzae type b. Lancet 340: 252–253.

  11. 11.

    John TJ et al. (1995): lAP’s immunization time table in pediatrics. Indian Pediatr 32: 1329–1331.

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Correspondence to B. Benjamin.

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Benjamin, B. Airway management in acute infectious croup syndromes. IJO & HNS 49, 269 (1997). https://doi.org/10.1007/BF02991289

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Keywords

  • Airway Management
  • Croup
  • Epiglottitis
  • Hypoxic Brain Damage
  • Nebulized Adrenaline