Airway management in acute infectious croup syndromes

  • B. Benjamin
Short communication


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.


Airway Management Croup Epiglottitis Hypoxic Brain Damage Nebulized Adrenaline 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  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.Google Scholar
  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.Google Scholar
  3. 3.
    Chameides L, Hazinski MF, (1994): Pediatric basic life support. In Pediatric Advanced Life Support. American Heart Association, USA.Google Scholar
  4. 4.
    Auchterlonie IA, Benjamin B. (1985): Neck radiographs in croup syndrome. Letter: Arch Dis Child 60: 288.CrossRefGoogle Scholar
  5. 5.
    Kairys SW, Olmstead EM. (1989): Steroid treatment of laryngotracheitis; a meta-analysis of the evidence from randomized trials. Pediatrics, 83: 683–693.PubMedGoogle Scholar
  6. 6.
    Cruz MN, Stewart C, Rosenberg N. (1995): Use of dexamethasone in the outpatient management of acute laryngotracheitis. Pediatrics 96: 220–223.PubMedGoogle Scholar
  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.Google Scholar
  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.PubMedGoogle Scholar
  9. 9.
    Hinton W, Coss IJ, (1987): Croup, nebulized adrenaline and preservatives. Anesthesia 42: 436–437.CrossRefGoogle Scholar
  10. 10.
    Jonsdottir KE. (1992): Immunisation of infants in Iceland against Haemophilus influenzae type b. Lancet 340: 252–253.PubMedCrossRefGoogle Scholar
  11. 11.
    John TJ et al. (1995): lAP’s immunization time table in pediatrics. Indian Pediatr 32: 1329–1331.Google Scholar

Copyright information

© Association of Otolaryngologists of India 1997

Authors and Affiliations

  • B. Benjamin
    • 1
  1. 1.Chennai

Personalised recommendations