Abstract
Acute upper airway obstruction presents an immediate threat to life. Following loss of the upper airway, hypoxemia with resultant cardiac arrest and death can ensue within minutes. Inspiratory stridor (a harsh, usually high–pitched sound) is the hallmark of upper airway obstruction. This is not to say, however, that upper airway obstruction cannot occur in the absence of stridor, because profound degrees of obstruction may manifest silently if airflow is nearly absent. When confronted with a child who has acute upper airway obstruction, the practitioner must assess the degree of obstruction quickly and accurately. The possibility of progression to complete airway obstruction with hypoxemia and cardiac arrest must be appreciated. Delaying intervention in a child whose airway is unstable may be costly, but unnecessary instrumentation in a child who has stable upper airway obstruction may precipitate a crisis.
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American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2003;98(5):1269–77.
Borland LM, Colligan J, Brandom BW. Frequency of anesthesia-related complications in children with Down syndrome under general anesthesia for noncardiac procedures. Paediatr Anaesth. 2004;14(9):733–8.
Chaten FC, Lucking SE, Young ES, et al. Stridor: intracranial pathology causing postextubation vocal cord paralysis. Pediatrics. 1991;87:39.
Coté CJ, Hartnick CJ. Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children? Paediatr Anaesth. 2009;19 Suppl 1:66–76.
Graf J, Stein F. Tracheitis in pediatric patients. Semin Pediatr Infect Dis. 2006;17(1):11–3.
Grein AJ, Weiner GM. Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation. Cochrane Database Syst Rev. 2005;(2):CD003314.
Hadjikoutis S, Wiles CM. Respiratory complications related to bulbar dysfunction in motor neuron disease. Acta Neurol Scand. 2001; 103(4):207–13.
Herrera P et al. The current state of congenital tracheal stenosis. Pediatr Surg Int. 2007;23(11):1033–44. Epub 2007 Aug 22.
Infosino A. Pediatric upper airway and congenital anomalies. Anesthesiol Clin North America. 2002;20(4):747–66.
Kamin W. Diagnosis and management of respiratory involvement in Hunter syndrome. Acta Paediatr Suppl. 2008;97(457): 57–60.
King EF, Blumin JH. Vocal cord paralysis in children. Curr Opin Otolaryngol Head Neck Surg. 2009;17(6):483–7.
Levin R, Kissoon N, Froese N. Fibreoptic and videoscopic indirect intubation techniques for intubation in children. Pediatr Emerg Care. 2009;25(7):479; quiz 480–2.
Mace SE, Khan N. Needle cricothyrotomy. Emerg Med Clin North Am. 2008;26(4):1085–101, xi.
Masters IB. Congenital airway lesions and lung disease. Pediatr Clin North Am. 2009;56(1):227–42, xii.
McAllister JD, Gnauck KA. Rapid sequence intubation of the pediatric patient. Fundamentals of practice. Pediatr Clin North Am. 1999; 46(6):1249–84.
McNiece WL, Dierdorf SF. The pediatric airway. Semin Pediatr Surg. 2004;13(3):152–65.
Nicolai T. Therapeutic concepts in upper airway obstruction. Paediatr Respir Rev. 2004;5(1):34–9.
Pohunek P. Development, structure and function of the upper airways. Paediatr Respir Rev. 2004;5(1):2–8.
Rutter MJ. Evaluation and management of upper airway disorders in children. Semin Pediatr Surg. 2006;15(2):116–23.
Shimbori H, Ono K, Miwa T, et al. Comparison of the LMA-ProSeal and LMA-Classic in children. Br J Anaesth. 2004;93(4):528–31.
Weiss M, Engelhardt T. Proposal for the management of the unexpected difficult pediatric airway. Paediatr Anaesth. 2010;20(5): 454–64.
Worley G, Witsell DL, Hulka GF. Laryngeal dystonia causing inspiratory stridor in children with cerebral palsy. Laryngoscope. 2003;113(12):2192–5.
Zelicof-Paul A, Smith-Lockridge A, Schnadower D, et al. Controversies in rapid sequence intubation in children. Curr Opin Pediatr. 2005;17(3):355–62.
Zur KB, Litman RS. Pediatric airway foreign body retrieval: surgical and anesthetic perspectives. Paediatr Anaesth. 2009;19 Suppl 1: 109–17.
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Lucking, S.E. (2012). Upper Airway Obstruction. In: Lucking, S., Maffei, F., Tamburro, R., Thomas, N. (eds) Pediatric Critical Care Study Guide. Springer, London. https://doi.org/10.1007/978-0-85729-923-9_22
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DOI: https://doi.org/10.1007/978-0-85729-923-9_22
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