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Acute epiglottitis in children and adults. Nasotracheal intubation, tracheostomy or careful observation? Current status in Scandinavia

Published online by Cambridge University Press:  29 June 2007

H. Arndal*
Affiliation:
Department of Otolaryngology, Hillerød Hospital, DK-3400 Hillerød, Denmark.
U. K. Andreassen
Affiliation:
Department of Otolaryngology, Hillerød Hospital, DK-3400 Hillerød, Denmark.
*
H. Arndal, M.D., Department of Otolaryngology, Gentofte Hospital, DK-2900 Hellerup, Denmark.

Abstract

A review was performed of the treatment of 92 patients with acute epiglottitis with special reference to the different procedures employed in children and adults. Intubation was performed in 74 per cent of the children but in only six per cent of the adults. More than half of the children were initially observed only, but of these 58 per cent eventually needed intubation. No deaths occurred. We present our management protocol as well as a survey of the routine management of acute epiglottitis in children in the five Scandinavian countries. The number of initially observed patients ranged from nil per cent in Iceland to 35 per cent in Finland. When an artifical airway is needed, 92–100 per cent of the patients are intubated, 0-8 per cent tracheostomized, and 0-5 per cent one or the other, as a standard procedure. Tracheostomy is performed in departments where the facilities do not permit sufficient observation of patients treated by intubation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1988

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References

Andreassen, U. K., Hancke, A. B., Leth, N. K., Husum, B. and Tos, M. (1983) Acute epiglottitis. A management protocol based on a 15-year material. Journal of Oto-Rhino-laryngology, 45: 1319.Google ScholarPubMed
Andreassen, U. K., Husum, B., Tos, M. and Leth, N. (1984) Acute epiglottitis in adults. A management protocol based on a 17-year material. Acta Anaesthesiologica Scandinavica, 28: 155157.CrossRefGoogle ScholarPubMed
Battaglia, J. D. and Lockhart, C. H. (1975) Management of acute epiglottitis nasotracheal intubation. American Journal of Disease of Children, 129: 334336.Google ScholarPubMed
Baxter, J. D. and Pashley, N. R. T. (1977) Acute epiglottitis-25 years' experience in management. The Montreal Children's Hospital. Journal of Otolaryngology, 6: 473476.Google Scholar
Breivik, H. and Klaastad, Ø. (1978) Acute epiglottitis in children. Review of 27 patients. British Journal of Anesthesiology, 50: 505510.CrossRefGoogle ScholarPubMed
Broniatowski, M. (1985) Epiglottitis. Ear, Nose and Throat Journal, 64: 2227.Google ScholarPubMed
Buchmann, G. and Riskär, N. (1967) Laryngitis stridula hos børn behandlet med langvarig intubation. Nordisk Medicin, 77: 642.Google Scholar
Editorial (1978) Acute epiglottitis. The Lancet, i: 12941295.Google Scholar
Fryksmark, U., Lundgren, K., Mannerberg, L. and Toremalm, N.G. (1981) Akut epiglottic. Ett 10-årsmaterial. Svensk Otolaryngologisk Forening nr. 2.Google Scholar
Hannallah, R. M. and Rosales, J. K. (1978) Acute epiglottitis: current management and review. Canadian Anaesthetists Society Journal, 25: 8491.Google Scholar
Lockhart, C. H. (1981) The experts opine. Anaesthesiology, 25: 332338.Google Scholar
McNelis, F. L. (1985) Medical and legal management of adult acute epiglottitis. Laryngoscope, 95: 125127.CrossRefGoogle ScholarPubMed
MjeØn, S., Dahl, T., Swensen, T. and Westheim, A. (1979) Acute epiglottitis in children. An evaluation of the role of tracheostomy. Journal of Laryngoly and Otology, 93: 9951001.CrossRefGoogle Scholar
Oh, T. H. and Motoyama, E. K. (1977) Comparison of nasotracheal intubation and tracheostomy in management of acute epiglottitis. Anesthesiology, 46: 214216.Google Scholar
Olofsson, J., Boivie, A., Heldtander, P., Kinnefors, A. and Lindholm, S. (1984) Acute epiglottitis. A review of 474 chidlren with special reference to tracheostomy and intubation. Acta Otolaryngologica Supplementum, 412: 3336.Google Scholar
Rapkin, R. H. (1972) The diagnosis of epiglottitis. Simplicity and reliability of radiographs of the neck in the differential diagnosis of the croup syndrome. Journal of Pediatrics 80: 9698.CrossRefGoogle ScholarPubMed
Rapkin, R. H. (1973) Tracheostomy in epiglottitis. Pediatrics 52: 426429.Google Scholar
Sinclair, S. E. (1941) Haemophilus influenza type B in acute laryngitis with bacteriemia. Journal of the American Medical Association, 117: 170173.Google Scholar
Tos, M. (1973) Nasotracheal intubation in acute epiglottitis. Archi-ves of Otolaryngology, 97: 373375.CrossRefGoogle Scholar
Tucker, J. A. and Silberman, H. D. (1972) Tracheotomy. In Ken-dig, E. L. ed. Disorders of the Respiratory Tract in Children, vol. 2, pp. 12191230. Saunders, Philadephia.Google Scholar