Airway management and acute airway obstruction

Adrenal corticosteroids exert a strong suppressive influence on the basic inflammatory response that leads to tissue swelling. The corticosteroid effect is nonspecific. In upper airway obstruction caused by edema from infection, allergy, or trauma, corticosteroids will exert some degree of suppressive effect. The steroid effect is local and directly proportional to the concentration of steroids in the inflamed tissue. In upper airway obstruction steroids should be delivered to the inflamed tissue in high concentration with the least delay. Dexamethasone and methylprednisolone produce high blood levels within 15 to 30 minutes of intramuscular injection. Recommended initial doses for acute airway obstruction are dexamethasone, 1.0 to 1.5 mg/kg, or methylprednisolone, 5 to 7 mg/kg. The risk of harm from steroid therapy of 24 hours or less is negligible.

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Acute Airway Obstruction from Megaoesophagus Secondary to Achalasia Evaluated with Flexible Bronchoscope

Case Reports in Anesthesiology ◽

10.1155/2021/8815376 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Jun D. Parker

Keyword(s):

Emergency Department ◽

Airway Management ◽

Airway Obstruction ◽

Diagnostic Tool ◽

Flexible Bronchoscope ◽

Management Planning ◽

Tracheal Compression ◽

Acute Airway Obstruction

A 94-year-old female presented to the emergency department with acute expiratory stridor. In the absence of an otorhinolaryngologist, an urgent laryngoscopy was performed using a flexible bronchoscope by an anaesthesiologist in the emergency department leading to a change in management. Subsequent radiographs confirmed severe tracheal compression from megaoesophagus secondary to achalasia as the cause of acute airway obstruction. Use of flexible bronchoscope as a diagnostic tool by an anaesthesiologist to evaluate a patient presenting with signs of acute airway obstruction may lead to a safer and more careful airway management planning. Suggestions are also made regarding establishment of emergency surgical airways when conventional approaches fail.

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Prolapsed Nasal Polyp Causing Acute Airway Obstruction: An Exceptional Presentation

ORL ◽

10.1159/000513564 ◽

2021 ◽

pp. 1-3

Author(s):

Krupa R. Patel ◽

Ashton E. Lehmann ◽

Aria Jafari ◽

Daniel L. Faden

Keyword(s):

Airway Obstruction ◽

Nasal Polyp ◽

Nasal Polyposis ◽

Upper Airway ◽

Rare Presentation ◽

First Case ◽

Acute Airway Obstruction ◽

History Of ◽

Sinonasal Symptoms ◽

Or History

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.

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Negative pressure pulmonary oedema after acute airway obstruction

European Journal of Anaesthesiology ◽

10.1097/00003643-200606001-00915 ◽

2006 ◽

Vol 23 (Supplement 37) ◽

pp. 255

Author(s):

U. Spreng

Keyword(s):

Airway Obstruction ◽

Pulmonary Oedema ◽

Negative Pressure ◽

Negative Pressure Pulmonary Oedema ◽

Acute Airway Obstruction

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Treacher Collins syndrome with acute airway obstruction

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/s0165-5876(00)00336-0 ◽

2000 ◽

Vol 54 (1) ◽

pp. 41-43 ◽

Cited By ~ 10

Author(s):

Fahim Ahmed Shah ◽

S. Ramakrishna ◽

Vijendra Ingle ◽

J.E. Dada ◽

Mazin Al Khabori ◽

...

Keyword(s):

Airway Obstruction ◽

Treacher Collins Syndrome ◽

Acute Airway Obstruction

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Recurrent transient loss of airway secondary to regurgitated pedunculated hypopharyngeal liposarcoma

BMJ Case Reports ◽

10.1136/bcr-2020-240503 ◽

2021 ◽

Vol 14 (5) ◽

pp. e240503

Author(s):

Craig John Hickson ◽

Omar Ahmed ◽

Juliet Laycock ◽

Robert Hone

Keyword(s):

Airway Obstruction ◽

Multidisciplinary Team ◽

Rare Case ◽

Atypical Presentation ◽

Team Meetings ◽

Acute Airway Obstruction ◽

History Of ◽

Transient Loss ◽

Multidisciplinary Team Meetings

We describe a rare case of hypopharyngeal liposarcoma with an atypical presentation. The patient presented with a 3-month history of intermittent, transient acute airway obstruction. In between episodes, he was asymptomatic. A pedunculated tumour originating in the postcricoid region was seen to be suspended into the oesophagus and intermittently regurgitated into the larynx to cause airway obstruction. The lesion was endoscopically removed and examined histologically to confirm the diagnosis. On-going management of rare lesions such as this should be through multidisciplinary team meetings at a tertiary sarcoma centre.

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Subglottic acute lymphoblastic leukaemia

BMJ Case Reports ◽

10.1136/bcr-2018-226364 ◽

2018 ◽

Vol 11 (1) ◽

pp. e226364

Author(s):

Shilpa Ojha ◽

Julian Gaskin ◽

Michael Saunders

Keyword(s):

Differential Diagnosis ◽

Paediatric Patient ◽

Acute Lymphoblastic Leukaemia ◽

Airway Obstruction ◽

Lymphoblastic Leukaemia ◽

Unusual Case ◽

Acute Airway Obstruction ◽

History Of ◽

Low Threshold

Acute lymphoblastic leukaemia (ALL) is one of the the most common malignancies of childhood and can occasionally present as acute airway obstruction. We present the unusual case of a 1-year-old boy who was referred to our Paediatric Otolaryngology (ENT) clinic with a recurrent history of croup. This is the first reported case of localised ALL presenting as a subglottic mass in a paediatric patient. It highlights the need to have a broader differential diagnosis in children presenting with ‘recurrent croup’ including extramedullary presentation of leukaemia and to have a low threshold for performing endoscopy in such cases.

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