Document Detail

Acute epiglottitis: a different approach to management.
MedLine Citation:
PMID:  3276447     Owner:  NLM     Status:  MEDLINE    
Between January 1979 and October 1986, 349 patients with epiglottitis were admitted to the Royal Children's Hospital, Melbourne, Australia. Forty-five (13%) patients were not intubated, 291 (83%) were managed by nasotracheal intubation and spontaneous respiration without sedation, three (1%) received continuous positive airway pressure, and ten (3%) were ventilated. The 294 patients who were not ventilated were intubated for a mean of 18 +/- 9.5 (SD) h; 90% were extubated within 24 h. Criteria for extubation included resolution of fever (less than 37.5 degrees C), passage of time (12 to 16 h), and improvement in the general appearance of the child. Laryngoscopy was not performed before extubation. Providing there is always a doctor present who can reintubate if accidental extubation occurs, routine use of sedation, paralysis and mechanical ventilation, and pre-extubation laryngoscopy are not required for the management of children with uncomplicated epiglottitis, and their use may prolong the period of intubation.
W Butt; F Shann; C Walker; J Williams; A Duncan; P Phelan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  16     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1988 Jan 
Date Detail:
Created Date:  1988-02-29     Completed Date:  1988-02-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  43-7     Citation Subset:  AIM; IM    
Department of Intensive Care, Royal Children's Hospital, Parkville, Victoria, Australia.
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MeSH Terms
Acute Disease
Airway Obstruction / etiology,  therapy
Child, Preschool
Epiglottitis / complications,  mortality,  therapy*
Intensive Care Units
Intubation, Intratracheal / methods*
Laryngitis / therapy*
Positive-Pressure Respiration
Time Factors

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