phenylephrine-hydrochloride and Laryngitis

In 40 cases of acute epiglottitis in children, intubation was the chosen method for the management of airway obstruction. Six patients were treated without the establishment of an artificial airway, and no tracheostomies were done. No patients who were admitted to the hospital died of airway obstruction, although one sustained irreversible brain damage before admission, and two died of overwhelming infectionmthe average duration of intubation was 2.days and the average hospital stay was 5.days. Two children developed subglottic granulation tissue that was removed successfully and did not recur. Nasotracheal intubation is an acceptable method of management of epiglottitis.

Topics: Acute Disease; Airway Obstruction; Brain Damage, Chronic; Child; Child, Preschool; Clinical Trials as Topic; Epiglottis; Female; Granulation Tissue; Humans; Infant; Infant, Newborn; Intubation, Intratracheal; Laryngitis; Laryngostenosis; Length of Stay; Male; Mouth; Nose; Pneumonia; Time Factors

Acute epiglottitis is a potentially fatal upper respiratory tract infection. In this paper, we describe the use of flexible nasoendoscopy, both in establishing the diagnosis and during the subsequent airway management of adults with acute epiglottitis.

Topics: Acute Disease; Adult; Endoscopes; Epiglottitis; Humans; Laryngismus; Laryngitis; Nose

One hundred and forty-eight cases of acute epiglottitis in children treated at the University of Rochester's Strong Memorial Hospital and two affiliated community hospitals between 1965 and 1983 are reviewed retrospectively. Patients seen prior to 1975 were usually managed with tracheotomy and intravenous antibiotics, while those after 1975 with nasotracheal intubation, antibiotics and steroids. Tracheotomy and nasotracheal intubation were equally safe in controlling the upper airway. We compared our results with other series, primarily from children's hospitals, using nasotracheal intubation and found comparable results. Steroids provided no significant effect on the duration of intubation or infectious complications, but was associated with gastrointestinal bleeding. Long- and short-term complications of intubation, including self-extubation are discussed. We conclude that nasotracheal intubation is a safe method of management for acute epiglottitis in the community hospital.

Topics: Acute Disease; Anti-Bacterial Agents; Child; Child, Preschool; Combined Modality Therapy; Epiglottitis; Hospitals, Community; Humans; Intubation; Laryngitis; New York; Nose; Retrospective Studies; Steroids; Time Factors; Trachea; Tracheotomy

Management of the airway in acute epiglottitis is still controversial. One argument against intubation as opposed to tracheostomy is the increased complications from prolonged intubation. We describe a study of 26 children treated for acute epiglottitis from 1971 to 1979. Included in this series are 16 consecutive patients who were treated by nasotracheal intubation and simultaneous medical therapy. Fifteen of the 16 patients extubated safely in less than 48 hours, significantly decreasing the possibility for complications.

Topics: Acute Disease; Child; Child, Preschool; Emergency Medical Services; Epiglottis; Female; Humans; Infant; Intubation, Intratracheal; Laryngitis; Male; Nose; Time Factors; Tracheotomy

20 of 34 patients with acute epiglottitis were treated with nasotracheal intubation. One patient died because of pneumonia, one patient was clinically dead when he arrived at hospital. After successful reanimation she died some hours later. All other patients left the hospital without any symptoms after an average stay of 12 days. The average duration of nasotracheal intubation was 39 hours. Nasotracheal intubation and adequate antibiotic therapy offer the most effective and secure approach to acute epiglottitis. A protocol for diagnostic and therapeutic regimen is presented.

Topics: Acute Disease; Adolescent; Child; Child, Preschool; Epiglottis; Female; Humans; Infant; Intubation, Intratracheal; Laryngitis; Length of Stay; Male; Nose; Time Factors

Topics: Child; Endoscopes; Endoscopy; Epiglottis; Fiber Optic Technology; Humans; Infant, Newborn; Laryngitis; Laryngoscopes; Laryngoscopy; Nose; Pharynx

Topics: Adult; Child; Croup; Epiglottis; Humans; Intubation, Intratracheal; Laryngitis; Nose

Intravenous vaccination of rats with either viable or Formalin-inactivated Mycoplasma pulmonis reduced the incidence and severity of lower respiratory tract lesions after intranasal challenge with viable organisms. Intranasal vaccination with killed organisms reduced the severity of rhinitis, but did not affect lesions in any other region of the respiratory tract. The maximum protection against upper tract lesions (rhinitis, otitis, and laryngotracheitis) was provided by intravenous immunization with viable organisms. Dual vaccination (intraperitoneal plus intranasal) with killed organisms provided no significant protection in any segment of the tract. However, these ineffective vaccine regimens did not potentiate the lesions. These results conclusively demonstrate that vaccination of rats against mycoplasma respiratory disease is feasible and also suggest that systemic vaccination may provide greater protection for the lungs than intranasal vaccination, at least when equivalent antigen doses are used.

Topics: Animals; Bacterial Vaccines; Immunity; Immunization; Injections; Injections, Intraperitoneal; Injections, Intravenous; Laryngitis; Mycoplasma; Mycoplasma Infections; Nose; Otitis; Pneumonia; Rats; Rhinitis

Topics: Acute Disease; Child, Preschool; Epiglottis; Female; Humans; Infant; Intubation, Intratracheal; Laryngitis; Male; Mouth; Nose

Topics: Croup; Intubation, Intratracheal; Laryngitis; Nose

Topics: Adult; Epiglottis; Humans; Intubation, Intratracheal; Laryngitis; Male; Nose

Topics: Acute Disease; Child, Preschool; Epiglottis; Female; Foreign Bodies; Humans; Laryngitis; Nose

The case histories of 150 children admitted to hospital with acute laryngotracheobronchitis (LTB) are reviewed. Relief of severe upper airway obstruction was achieved by nasotracheal intubation in 27 children (18%). There was no mortality in this series. Nasotracheal intubation is therefore a safe and effective means of treating severe LTB. In addition, the importance of meticulous nursing care is stressed.

Topics: Acute Disease; Adolescent; Child; Child, Preschool; Croup; Diagnosis, Differential; Epiglottis; Female; Humans; Infant; Intubation, Intratracheal; Laryngitis; Male; Nose; Radiography; Tracheotomy

Topics: Anesthesia, Inhalation; Bacteriological Techniques; Child; Child, Preschool; Epiglottis; Haemophilus; Haemophilus influenzae; Humans; Intubation, Intratracheal; Laryngitis; Length of Stay; Nose; Staphylococcal Infections; Streptococcal Infections; Streptococcus pyogenes; Time Factors

Topics: Acute Disease; Adult; Child, Preschool; Epiglottis; Female; Humans; Infant; Intubation, Intratracheal; Laryngitis; Male; Nose; Polyvinyls; Postoperative Complications; Respiratory Insufficiency; Time Factors; Tracheotomy

Topics: Child; Child, Preschool; Deafness; First Aid; Humans; Laryngitis; Nose; Otorhinolaryngologic Diseases

Topics: Age Factors; Child; Child, Preschool; Diphtheria; Humans; Infant; Intubation, Intratracheal; Laryngitis; Measles; Nose; South Africa; Tracheotomy; Virus Diseases

Topics: Acute Disease; Age Factors; Antibodies; Blood; Bronchiolitis, Viral; Cell Line; Child, Preschool; Complement Fixation Tests; Cytopathogenic Effect, Viral; Feces; Female; Hemadsorption Inhibition Tests; Humans; Infant; Laryngitis; Male; Mumps virus; Nose; Pharynx; Pneumonia; Population Surveillance; Sex Factors; Time Factors

Topics: Child; Child, Preschool; Epiglottis; Humans; Infant; Intubation, Intratracheal; Laryngitis; Male; Nose; Polyvinyls; Respiratory Insufficiency

Topics: Carcinoma, Basal Cell; Chromium; Humans; Laryngeal Diseases; Laryngitis; Nose; Nose Neoplasms; Occupational Diseases; Pharyngitis; Pharynx; Toxicology

Topics: Humans; Laryngitis; Larynx; Nose; Paranasal Sinuses