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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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References

Andreassen, U. K., Hancke, A. B., Leth, N. K., Husum, B., Tos, M. (1983) Acute epiglottis. A management protocol based on a 15-year material. ORL Journal for Oto-Rhino-Laryngology and Its Related Specialties, 45: 13–19.CrossRefGoogle ScholarPubMed
Andreassen, U. K., Husum, B., Tos, M., Leth, N. (1984) Acute Epiglottitis in Adults. A Management Protocol Based on a 17-Year Material. Acta Anaesthesiologica Scandinavica, 28: 155–157.CrossRefGoogle ScholarPubMed
Breivik, H., Klaastad, Ø. (1978) Acute epiglottitis in children. Review of 27 patients. British Journal of Anaesthesia, 50: 505–510.CrossRefGoogle ScholarPubMed
Buchmann, G., Riskær, N. (1967) Laryngitis stridula hos born behandlet med langvarig intubation. Nordisk Medicin, 78: 642.Google Scholar
Clements, D. A., Gilbert, G. L. (1990) Immunization for the prevention of Haemophilus influenzae type b infections: a review. Australian and New Zealand Journal of Medicine, 20: 828–834.CrossRefGoogle ScholarPubMed
Cox, G. J., Bates, G. J., Drake-Lee, A. B., Watson, D. J. (1988) The use of flexible nasoendoscopy in adults with acute epiglottitis. Annals of the Royal College of Surgeons of England, 70: 361–362.Google ScholarPubMed
Editorial(1978) Acute epiglottitis. Lancet, i: 1294–1295.Google Scholar
Eskola, J., Peltola, H., Takala, A. K., Käyhty, H., Hakulinen, M., Karanko, V., Kela, E., Rekola, P., Rönnberg, P.-R., Samuelson, J. S., Gorden, L. K., Mäkel¨a, P. H. (1987) Efficacy of Haemophilus influenzae type b polysaccharide-diphtheria toxoid conjugate vaccine in infancy. New England Journal of Medicine, 317: 717–722.CrossRefGoogle ScholarPubMed
Hannallah, R., Rosales, J. K. (1978) Acute epiglottitis: current management and review. Canadian Anaesthetists' Society Journal, 25: 84–91.CrossRefGoogle ScholarPubMed
Hugosson, S., Ekedahl, C.Olcén, P. (1991) Alia patienter med akut epiglottit behöver övervakning på intensivvårdsavdelning. Läkartidningen, 88: 504–506.Google Scholar
Oh, T. H., Motoyama, E. K. (1977) Comparison of nasotracheal intubation and tracheostomy in management of acute epiglottitis. Anesthesiology, 46: 214–216.CrossRefGoogle ScholarPubMed
Rapkin, R. H. (1972) The diagnosis of epiglottitis: simplicity and reliability of radiographs of the neck in the differential diagnosis of the croup syndrome. Journal of Pediatrics, 80: 96–98.CrossRefGoogle ScholarPubMed
Sinclair, S. E. (1941) Haemophilus influenzae type b in acute laryngitis with bacteremia. Journal of the American Medical Association, 117: 170–173.CrossRefGoogle Scholar
Trollfors, B., Nylen, O., Strangert, K. (1990) Acute epiglottitis in children and adults in Sweden 1981–83. Archives of Disease in Childhood, 65: 491–494.CrossRefGoogle Scholar
Träff, B., Tos, M. (1969) Nasotracheal intubation in acute epiglottitis. Acta Otolaryngologica Scandinavica, 68: 363–368.CrossRefGoogle ScholarPubMed
Wurtele, P. (1990) Acute epiglottitis in children and adults: A largescale incidence study. Otolaryngology-Head and Neck Surgery, 103: 902–908.CrossRefGoogle ScholarPubMed