Upper Airway Obstruction

The Pediatric Airway

Figure 1: Adult vs. Pediatric Airway: Major Differences

(From Fuhrman and Zimmerman, Pediatric Critical Care, 2016)


Figure 3: Laryngomalacia (noted dynamic inspiratory collapse) 

Figure 4: Epiglottitis as seen with laryngoscopy and classic "thumb sign" on lateral neck XR

Figure 5: HPV papillomatosis leading to upper airway obstruction


    Overall goals depending on the underlying etiology:

Reduce Inflammation

Reduce Work of Breathing by Improving Flow/Turbulence

Stent Open the Area of Obstruction

Reduce Work of Breathing by Decreasing Flow Requirement

Bypass the Area of Obstruction


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3) D.W. Johnson, S. Jacobson, P.C. Edney: A comparison of nebulized budesonide, intramuscular dexamethasone, and placebo for moderately severe croup. N Engl J Med.339 (8):498-503 1998

4) J.E. Weber, C.R. Chudnofsky, J.G. Younger, et al.: A randomized comparison of helium-oxygen mixture (Heliox) and racemic epinephrine for the treatment of moderate to severe croup. Pediatrics. 107 (6):E96 200111389294

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