Abstract
One hundred and thirty-seven patients with acute epiglottitis were studied retrospectively with regard to the efficacy and safety of short duration of intubation and hospitalisation. All patients were treated by nasotracheal intubation and antibiotic therapy. Inhalation anesthesia with halothane/oxygen was the preferred method for intubation (80.3%). Extubation was based on clinical improvement in 88.1% and on laryngoscopy in 11.9% of cases. Fifty-four percent of the patients were extubated successfully within 24 h and 94.8% within 48h. Three patients (2.2%) had to be reintubated once. The mean duration of intubation was 27.6h (range 8–86) and of hospitalisation 4.0 days (range 2–9). Two children (1.5%) died because of severe hypoxic brain damage due to cardiorespiratory arrest prior to hospital admission. A follow-up study conducted via the family physician revealed only two major complications (granulation polyp of the vocal cords, 1; long-lasting hoarseness, 1). It is concluded that short duration of intubation and hospitalisation are effective and safe in the management of acute epiglottitis.
Similar content being viewed by others
References
Barker GA (1979) Current management of croup and epiglottitis. Pediatr Clin North Am 26:565
Battaglia JD, Lockhardt CH (1975) Management of acute epiglottitis by nasotracheal intubation. Am J Dis Child 129:334
Bottenfield GW, Arcinue EL, Sarnaik A, Jewell MR (1980) Diagnosis and management of acute epiglottitis — Report of 90 consecutive cases. Laryngoscope 90:822
Breivik H, Klaastad O (1978) Acute epiglottitis in children. Br J Anaesthesiol 50:505
Briggs WH, Altenau MM (1980) Acute epiglottitis in children. Otolaryngol Head Neck Surg 88:665
DiTirro FR, Silver MH, Hengerer AS (1984) Acute epiglottitis: evolution of the management in the community hospital. Int J Pediatr Otorhinolaryngol 7:145
Enoksen A, Bryne H, Hoel TM, Havnen J (1979) Epiglottitis acuta treated with nasotracheal intubation. Acta Anaesth Scand 23:422
Faden HS (1979) Treatment of Haemophilus influenzae type B epiglottitis. Pediatrics 63:402
Kanter RK, Watchko JF (1984) Pulmonary edema associated with upper airway obstruction. Am J Dis Child 138:356
Lacroix J, Blanc VF, Weber M, Perreault G (1982) Etude de 100 cas consécutifs d'épiglottite aigue. Union Med Can 111:774
Lazoritz S, Saunders BS, Bason WM (1979) Management of acute epiglottitis. Crit Care Med 7:285
Molteni RA (1976) Epiglottitis: incidence of extraepiglottic infection. Pediatrics 58:526
Murphy D, Todd J (1979) Treatment of ampicillin-resistant Haemophilus influenzae in soft tissue infections with high doses of ampicillin. J Pediatr 94:983
Nussbaum E (1983) Fiberoptic laryngoscopy as a guide to tracheal extubation in acute epiglottitis. J Pediatr 102:269
Orlowsky JP, Ellis NG, Amin NP, Crumrine RS (1980) Complications of airway intrusion in 100 consecutive cases in a pediatric ICU. Crit Care Med 8:324
Pfenninger J, Schaad UB, Lütschg J, Nussbaumer A, Zellweger U (1982) Cefuroxime in bacterial meningitis. Arch Dis Child 57:539
Phelan PD, Mullins GC, Laundau LI, Duncan AW (1980) The period of nasotracheal intubation in acute epiglottitis. Anaesth Intensive Care 8:402
Rothstein P, Lister G (1983) Epiglottitis — duration of intubation and fever. Anesth Analg 62:785
Rundcrantz H, Karlsson G (1983) Acute epiglottitis treated by intubation. Int J Pediatr Otorhinolaryngol 5:261
Travis KW, Todres ID, Shannon DC (1977) Pulmonary edema associated with croup and epiglottitis. Pediatrics 59:695
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gerber, A.C., Pfenninger, J. Acute epiglottitis: management by short duration of intubation and hospitalisation. Intensive Care Med 12, 407–411 (1986). https://doi.org/10.1007/BF00254671
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00254671