TY - JOUR
T1 - The Characteristics of Children With Epiglottitis Who Develop the Complication of Pulmonary Edema
AU - Bonadio, William A.
AU - Losek, Joseph D.
PY - 1991/2
Y1 - 1991/2
N2 - A review was performed of 234 consecutive cases of epiglottitis that occurred during a 20-year period to delineate the rate of, and clinical characteristics associated with, the complication of pulmonary edema. As a result of the prior utilization of a "dual" management protocol, there were 170 children who received endotracheal intubation, and 64 children managed without placement of an artificial airway. In all, five children (2.1%) of varying ages developed this complication—all experienced severe airway obstruction progressing to respiratory arrest, with evidence of pulmonary edema developing shortly after endotracheal intubation. Two of these five children died due to complications resulting from upper airway obstruction—induced cardiorespiratory arrest. By contrast, no child with milder degrees of airway obstruction managed without an artificial airway exhibited clinical evidence of pulmonary edema. Several possible mechanisms for the development of this complication are described. Pulmonary edema associated with epiglottitis is an uncommon complication that can occur following endotracheal intubation in those patients with marked respiratory insufficiency. An artificial airway should be instituted in all cases of pediatric epiglottitis—the potential complication of pulmonary edema should be anticipated before placement of an artificial airway, especially in those patients with a severe degree of upper airway obstruction.
AB - A review was performed of 234 consecutive cases of epiglottitis that occurred during a 20-year period to delineate the rate of, and clinical characteristics associated with, the complication of pulmonary edema. As a result of the prior utilization of a "dual" management protocol, there were 170 children who received endotracheal intubation, and 64 children managed without placement of an artificial airway. In all, five children (2.1%) of varying ages developed this complication—all experienced severe airway obstruction progressing to respiratory arrest, with evidence of pulmonary edema developing shortly after endotracheal intubation. Two of these five children died due to complications resulting from upper airway obstruction—induced cardiorespiratory arrest. By contrast, no child with milder degrees of airway obstruction managed without an artificial airway exhibited clinical evidence of pulmonary edema. Several possible mechanisms for the development of this complication are described. Pulmonary edema associated with epiglottitis is an uncommon complication that can occur following endotracheal intubation in those patients with marked respiratory insufficiency. An artificial airway should be instituted in all cases of pediatric epiglottitis—the potential complication of pulmonary edema should be anticipated before placement of an artificial airway, especially in those patients with a severe degree of upper airway obstruction.
UR - http://www.scopus.com/inward/record.url?scp=0025971120&partnerID=8YFLogxK
U2 - 10.1001/archotol.1991.01870140093014
DO - 10.1001/archotol.1991.01870140093014
M3 - Article
C2 - 1991065
AN - SCOPUS:0025971120
SN - 0886-4470
VL - 117
SP - 205
EP - 207
JO - JAMA Otolaryngology - Head and Neck Surgery
JF - JAMA Otolaryngology - Head and Neck Surgery
IS - 2
ER -