Evaluation and management of upper airway obstruction
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- 作者：Robert Primhak
- 关键词：airway obstruction ; obstructive sleep apnoea ; laryngeal disease ; nasopharynx ; croup
- 刊名：Paediatrics and Child Health
- 出版年：2013
- 出版时间：July, 2013
- 年：2013
- 卷：23
- 期：7
- 页码：301-306
- 全文大小：208 K
文摘
This review provides an overview of acute and chronic upper airway obstruction. Glottic or subglottic obstruction affects the airway when it is a single channel. This is potentially life-threatening and presents with stridor and/or respiratory distress. Supraglottic airway obstruction generally affects the nasal or nasopharyngeal airway and tends to predominantly affect breathing during sleep. There are a number of different causes for each of these clinical problems.
In acute glottic or subglottic obstruction, management consists of a rapid assessment and the establishment of a secure airway when the obstruction is life-threatening. Thereafter the management will be targeted on the underlying condition. In supraglottic airway obstruction it is important to recognize that symptoms may be subtle and a high index of suspicion is needed, particularly when there are co-morbidities which make sleep-disordered breathing more likely. In severe supraglottic obstruction causing significant sleep-disordered breathing adenotonsillectomy is usually the treatment of choice, but other measures including non-invasive continuous positive airway pressure (CPAP) or ventilation may be necessary if this is unhelpful.