Upper Airway Obstruction Upper Airway Obstruction Potentially fatal
Upper Airway Obstruction
Upper Airway Obstruction § Potentially fatal § Misdiagnosed as Asthma or COPD § Multiple etiologies
Upper Airway Obstruction § Consists of the air conducting system Mouth Carina § Divided by the thoracic inlet into extrathoracic & intrathoracic § Extrathoracic Airway pharynx +larynx & extrathoracic trachea
Upper Airway Obstruction § The extrathoracic trachea 2 -4 cm intrathoracic trachea 9 -12 cm § Caliber 13 -25 mm men 10 -21 mm women § Stridor indicate severe obstruction <5 mm but not the location of narrowing
Upper Airway Obstruction Post intubation or Tracheostomy local edema , ulceration & granuloma most resolve 8 -12 weeks Closely related to Duration & Use High Pressure small volume cuff post extubation edema common in children
Upper Airway Obstruction Inhalation Injury Could be gradual 2 -12 hours Mucosal edema increased secretions obstruction by the sloughed epithelium Fire , explosion in closed space Facial burns , Hoarse voice Erythema oropharynx ? Effect of steroid
Upper Airway Obstruction Foreign Body aspiration Common in children Adults with decreased LOC CNS diseases Drugs ETOH
Upper Airway Obstruction Angioedema Hereditary C 1 esterase deficiency Ig. E Mediated Non Ig. E Mediated (NSAID & ACEI ) Rx Epinepherine Steroids Antihistamines
Upper Airway Obstruction Infections Croup children URTI viral infection Epiglotitis bacterial absence of cough & hoarseness of voice Ludwig's Angina cellulitis of mouth floor & submandibular area poor dentition Malignancy
Upper Airway Obstruction Diagnosis CXR sometimes helpful Spirometry insensitive till advanced stage shape changes even before volumes CT define the location 3 D reconstruction MRI superior estimating length & degree
Upper Airway Obstruction Treatment Racemic Epi Croup vasoconstriction decreasing edema Steroids Croup & Post extubation ? Helium postextubation , tracheal stenosis extrinsic compression Lower density & viscosity Laser , Stenting & Dilatation
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