Notfall + Rettungsmedizin

, Volume 15, Issue 2, pp 123–126 | Cite as

Allergische Obstruktion der oberen Atemwege

Leitthema
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Zusammenfassung

Hintergrund

Die Obstruktion der oberen Atemwege durch eine schwere Allergie oder Anaphylaxie kann bei Kindern zu Hypoxie und damit zu einem akut lebensbedrohlichen Ereignis führen. Vor allem Kinder unter 5 Jahren sind immer häufiger von Nahrungsmittelallergien betroffen und können neben anderen allergischen Symptomen bis hin zur Anaphylaxie eine Obstruktion der oberen Atemwege erleiden. Kofaktoren, die dies begünstigen, sind allergischen Disposition und Asthma bronchiale.

Klinik und Differenzialdiagnose

Leitsymptome der oberen Atemwegsobstruktion sind Stridor und Dyspnoe, die nach Antigenkontakt bei sonst gesunden Kindern plötzlich auftreten. Differenzialdiagnostisch ist die allergische Atemwegsobstruktion von anderen Ursachen wie Infektionen, Traumata und v. a. der Aspiration von Fremdkörpern zu unterscheiden.

Erstversorgung

Im Vordergrund der Erstversorgung stehen die Sicherung der Atemwege, die Applikation von Sauerstoff und der unmittelbare ärztlich begleitete Transport in eine Klinik mit pädiatrischer Fachabteilung. Adrenalin intramuskulär appliziert in einer Dosierung von 0,01 mg/kg Körpergewicht ist das Medikament der ersten Wahl. Zusätzlich sollte das Kind Adrenalin als Aerosol in vernebelter Form kontinuierlich inhalieren.

Schlüsselwörter

Obere Atemwegsobstruktion Kinder Allergie Anaphylaxie Adrenalin 

Allergic obstruction of the upper airway

Abstract

Background

Upper airway obstruction in children due to severe allergic reactions can cause hypoxemia which can in turn lead to an acute life-threatening situation. In particular food-induced anaphylaxis is increasing and appears to be most prevalent in children under the age of 5 years. Children with asthma and an allergic disposition are at a higher risk of developing severe allergy and anaphylaxis.

Symptoms

Stridor and dyspnea are the leading symptoms of upper airway obstruction in children. In cases of severe allergy, symptoms will develop suddenly after antigen exposure in otherwise healthy children. Other reasons for upper airway obstruction, such as infection, trauma and aspiration of foreign bodies into the pediatric airways should be excluded.

Management

Cornerstones of treatment are airway protection, administration of oxygen and immediate admission to a pediatric hospital with doctor-accompanied transport. The administration of intramuscular adrenaline at 0.01 mg/kg body weight and the administration of continuous nebulized adrenaline are recommended as first line treatment.

Keywords

Upper airway obstruction Children Allergy Anaphylaxis Adrenaline 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of AnaesthesiologySophia Children’s Hospital, Erasmus MC RotterdamRotterdamNiederlande

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