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Acute epiglottitis—25 years experience with nasotracheal intubation, current management policy and future trends

Published online by Cambridge University Press:  29 June 2007

U. K. Andreassen ,
S. Baer ,
T. G. Nielsen ,
S. L. Dahm  and
H. Arndal
U. K. Andreassen*
Affiliation:
Departments of Otolaryngology, Gentofte Hospital, University of Copenhagen.
S. Baer
Affiliation:
Departments of Otolaryngology, Gentofte Hospital, University of Copenhagen.
T. G. Nielsen
Affiliation:
Departments of Otolaryngology, and Glostrup Hospital, Gentofte Hospital, University of Copenhagen.
S. L. Dahm
Affiliation:
University of Copenhagen and the Department of Anaesthesia, Gentofte Hospital, University of Copenhagen.
H. Arndal
Affiliation:
Departments of Otolaryngology, and Glostrup Hospital, Gentofte Hospital, University of Copenhagen.
*
Ulrik Koks Andreassen, M.D., Department of Otolaryngology, post 55, KAS Gentofte, DK-2900 Hellerup, Denmark
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Abstract

During a 25-year period 168 adults and 111 children in Copenhagen County were treated for acute epiglottitis. Four patients, two children and two adults died, of these the two children and one adult had a cardiac arrest on arriving at the hospital.

Most children were treated by nasotracheal intubation while only some adults required nasotracheal intubation in order to secure the airway. Our data indicate that intubation of adults with epiglottitis is technically more difficult than in children.

The fibrelaryngoscope, a new diagnostic tool, is advocated, and was in this study used to establish the diagnosis in 12 unclear cases of acute epiglottitis.

The incidence of acute epiglottitis in children was calculated at 3.2/100,000 with a minor annual variation. As vaccination against Haemophilus influenzae type b becomes more common, the incidence will probably be markedly reduced, maybe even eradicated in children, but in adults the same reduction cannot be expected as the causative agent in this group is less frequently Haemophilus influenzae type b.

Keywords

Acute epiglottitisHaemophilus influenzae type bAnti-haemophilus type b vaccineFibrelaryngoscopeIntubationnasotracheal
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 106 , Issue 12 , December 1992 , pp. 1072 - 1075
Copyright
Copyright © JLO (1984) Limited 1992

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