Abstract
Introduction
Acute supraglottitis is a potentially life-threatening condition that often necessitates intensive care unit (ICU) admission for airway monitoring. The objective of this study was to identify clinical criteria that predict a benign course for patients with acute supraglottitis.
Methods
A prospective observational study was performed. Adult patients hospitalized in the ICU between 2007 and 2019 diagnosed with acute supraglottitis were included. All patients were treated with antibiotics and corticosteroids. Fiber optic laryngoscopy (FOL) was performed every 12 h, with each exam defined as “improving”, “no change” or “deteriorating” based on the presence of airway edema. Need for airway intervention was correlated to changes in the FOL exam.
Results
Of 146 patients included, 14 (10%) required intubation, ten on admission, and four during the first 6 h of ICU admission. FOL follow-up was performed on 528 occasions—427 (81%) exams showed improvement, 16 (3%) deterioration, and 85 (16%) with no change. On no occasions was improvement in FOL followed by deterioration. The median ICU length of stay was 3 (IQR 2–3.5) vs. 1 (IQR 1.0–1.25) day for patients who did or did not require intubation (p < 0.001), respectively.
Conclusion
Improvement in FOL exam accurately predicted the absence of need for intubation and might represent a criterion for early ICU discharge.
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CS: substantial contributions to conception and design, acquisition of data. Analysis and interpretation of data. Drafting the article, or revising it critically for important intellectual content, final approval of the version to be published. PDL (equal contribution first author). PDA: substantial contributions to conception. Drafting the article content. AR and YS: acquisition of data, analysis, and interpretation of data. J-YS: substantial contributions to concept and design. Substantial contributions to interpretation of data.
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The authors declared that there was not any financial support. None of the authors has any conflict of interest, financial or otherwise.
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The study was approved by the Institutional Review Board of the Shaare-Zedek Medical Center affiliated with the Hebrew University with a waiver from informed consent requirements.
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Chanan Shaul and Philip D. Levin equally contributed to this study.
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Shaul, C., Levin, P.D., Attal, P.D. et al. The management of acute supraglottitis patients at the intensive care unit. Eur Arch Otorhinolaryngol 279, 1425–1429 (2022). https://doi.org/10.1007/s00405-021-07174-w
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DOI: https://doi.org/10.1007/s00405-021-07174-w