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The characteristics of children with epiglottitis who develop the complication of pulmonary edema

W A Bonadio1, J D Losek

  • 1Medical College of Wisconsin, Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee.

Archives of Otolaryngology--Head & Neck Surgery
|February 1, 1991
PubMed

Insights

Pulmonary edema is a rare complication of pediatric epiglottitis, occurring in 2.1% of cases after endotracheal intubation. This complication was observed in children with severe airway obstruction, highlighting the need for careful airway management.

Area of Science:

  • Pediatric Emergency Medicine
  • Critical Care
  • Otolaryngology

Background:

  • Epiglottitis is a serious upper airway infection in children.
  • Pulmonary edema is a potential, though uncommon, complication of severe epiglottitis.
  • Management protocols for pediatric epiglottitis involve airway assessment and intervention.

Observation:

  • A 20-year review of 234 epiglottitis cases identified 5 children (2.1%) who developed pulmonary edema.
  • Pulmonary edema occurred in children with severe airway obstruction and respiratory arrest, shortly after endotracheal intubation.
  • No cases of pulmonary edema were observed in children with milder obstruction managed without an artificial airway.

Findings:

  • Severe upper airway obstruction in pediatric epiglottitis is associated with the development of pulmonary edema post-endotracheal intubation.
  • Two of the five affected children died from cardiorespiratory arrest secondary to airway obstruction.
  • Pulmonary edema appears to be linked to significant respiratory insufficiency and the stress of airway manipulation.

Implications:

  • Pulmonary edema is an uncommon but serious complication of pediatric epiglottitis, particularly after endotracheal intubation.
  • Anticipating and monitoring for pulmonary edema is crucial in intubated pediatric epiglottitis patients with severe obstruction.
  • While artificial airways are indicated, careful management and vigilance for this complication are essential in pediatric epiglottitis cases.

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