Acute Infections that Produce Upper Airway Obstruction

Balfour‐Lynn, Ian M.; Davies, Jane

doi:10.1016/b978-1-4377-1984-0.00025-5

Cited by 4 publications

(8 citation statements)

References 99 publications

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“… 3 Michael Balfour-Lynn reported infections like laryngotracheobronchitis, epiglottitis caused by H influenza B, bacterial tracheitis, diphtheria, retropharyngeal and peritonsillar abscess leading to upper airway obstruction. 4 Epstein-Barr virus, a common aetiological agent known to cause massively enlarged tonsils, tested negative in this patient. Appelblatt and Baker described a functional component to airway obstruction severe enough to warrant tracheostomy.…”

Section: Discussionmentioning

confidence: 73%

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Acute upper airway obstruction due to tonsillitis necessitating emergency cricothyroidotomy

2021

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A 17-year-old man was admitted to Accident & Emergency out of hours with unilateral tonsillar enlargement covering more than 75% of his oropharyngeal inlet. He appeared calm and stable on initial presentation, but in a short span of time rapidly deteriorated, leading to near complete airway obstruction necessitating an emergency awake cricothyroidotomy. Tracheostomy and tonsillectomy were done after this, he was ventilated postoperatively in intensive therapy unit and discharged home in a week. This is a rare clinical scenario in a patient presenting with palatine tonsillitis. A few subtle points in the history and examination alerted the team and prevented a risky inter hospital transfer for ear, nose and throat review. This is the first reported case in UK of palatine tonsillitis not due to infectious mononucleosis presenting with acute upper airway obstruction in a patient with no airway anomalies. It may also have been a varied presentation of COVID-19.

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Section: Discussionmentioning

confidence: 73%

“…The sudden deterioration could be due to the sheer size of the tonsil opposing the post pharyngeal wall or the surrounding inflammation and oedema causing obstruction as described by Balfour-Lynn and Wright. 4 An abscess was ruled out during the operation. Mouth breathing could lead to dryness and stickiness of the tonsils.…”

Section: Discussionmentioning

confidence: 99%

Acute upper airway obstruction due to tonsillitis necessitating emergency cricothyroidotomy

2021

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“…As a result, the majority of anaesthesia providers in these areas rely on manual palpation techniques to determine cuff pressure. Such approaches are prone to cuff hyperinflation [20,21] and may impose a mechanical strain as well as tissue-related complications [22][23][24]. If the intra-cuff pressure is also too low, the patient is at risk of aspiration.…”

Section: Randomizationmentioning

confidence: 99%

Endotracheal Tube Cuff Pressure Measurement Techniques: Safety and Reliability: A Randomized Comparative Study

Kampo¹,

Winsum²,

Fidelis³

et al. 2022

J Clin Anesth Pain Manag

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Objective:The purpose of this study was to examine cuff inflation techniques and corresponding pressure estimations, as well as associated complications, in patients undergoing general anaesthesia with intubation for cesarean delivery at the Tamale Teaching Hospital's obstetric unit.Methods: Finger palpation of the pilot balloon, predetermined volume of air, and a pressure gauge were used to measure endotracheal tube (ETT) cuff pressure after intubation. Associated side effects were determined after 24 hours of endotracheal tube extubation.Results: Data for 384 patients were included in the analysis. Cuff pressure measured among patients varied from < 20-30 cmH 2 O for the standard manometer group, 20 to 50 cmH 2 O for the predetermined volume of air group and < 20 to > 50 cmH 2 O for the finger palpation group. Side effects were recorded in 2.4% of patients from the standard manometer group, 53.2% from the predetermined volume of air group and 83.6% from the finger palpation group. Conclusion:The finger palpation of a pilot balloon technique for cuff pressure estimation was unreliable and prone to cuff over inflation and associated with post-extubation airway complaints. Cuff pressure estimation using the standard manometer was associated with satisfactory patient outcomes.

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“…In terms of causative pathologies leading to tracheostomy, the findings from the present study are largely supported by the current literature. 11,15 Balfour-Lynn et al have written extensively on the identification and management of URTIs such as epiglottitis, tracheitis and peritonsillar abscesses in the paediatric setting. 15 The authors expressed that a tracheostomy is rarely required for URTIs in the paediatric population.…”

Section: Causative Pathologymentioning

confidence: 99%

Associative factors for tracheostomy in patients presenting with stridor or upper airway obstruction

et al. 2022

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Objective This study aimed to identify associative factors for tracheostomy in patients presenting with airway obstruction. Methods Data from a tertiary hospital were reviewed to identify patients who presented with airway obstruction between 2009 and 2020. Patient demographics, causative pathology and treatments were analysed. Results The study identified 297 admitted patients. Of these, 66 underwent a tracheostomy and formed the ‘tracheostomy’ group and 231 formed the ‘other intervention’ group. The tracheostomy group had a higher mean age (p = 0.003), and higher percentages of males (p = 0.031) and smokers or ex-smokers (p = 0.020), compared to the other intervention group. The tracheostomy group also had a higher number of patients with a malignancy (p < 0.001) compared to the other intervention group. Conclusion Being older, male, a previous or current smoker, or developing airway obstruction due to a malignancy were found to be the main associative factors for requiring a tracheostomy.

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Acute Infections that Produce Upper Airway Obstruction

Cited by 4 publications

References 99 publications

Acute upper airway obstruction due to tonsillitis necessitating emergency cricothyroidotomy

Acute upper airway obstruction due to tonsillitis necessitating emergency cricothyroidotomy

Endotracheal Tube Cuff Pressure Measurement Techniques: Safety and Reliability: A Randomized Comparative Study

Associative factors for tracheostomy in patients presenting with stridor or upper airway obstruction

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