| Comparison of Nasotracheal Intubation and Tracheostomy in the Management of Upper Airway Obstruction in Children . |
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Ho Sang Pak, Sung Nyeun Kim, Woon Hyok Chung |
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Department of Anesthesiology, Catholic Medical College, Seoul, Korea. |
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| Abstract |
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Acute obstruction of the upper airway in children demands prompt diagnosis and treatment. The management is complex and therefore demands serious, detalled and expert attention. An artificial airway is often required to alleviate the obstruction and due consideration should then be given to the relative merits of the passage of an endotracheal tube and tracheostomy. These are measures which should be carried out early in the illness and must not be postponed until the child is in a critical condition when emergency intervention is often associated with a high incidence of morbidity and mortality. Tracheostomy has been the procedure of choice to relieve airway obstruction; however, in recent years several investigators have reported the encouraging results of nasotracheal intubation as an alternate procedure in the management of upper airway obstruction in children. The purpose of this report is to evaluate the relative effectiveness of two procedures; nasotracheal intubation ami tracheostomy, Nasotracheal intubation or tracheostomy were employed in the management of 27 cases, and it would appear that the two methods of handling airway obstractiorr wer.e equally satisfactory. It was suggested that nasotracheal intubation was superior to tracheostomy in terms of the duration of hospitalization (13,0 days vs. 21. 3 days) and intubation (108. 4 hours vs 167. 2 hours). All patients tolerated well the nasotracheal tube without accidental extubation. |
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