Related Experiment Videos
Bacterial tracheitis in children
G F Kasian1, W T Bingham, J Steinberg
1Department of Pediatrics, University Hospital, University of Saskatchewan, Saskatoon.
Insights
Nasotracheal intubation safely manages bacterial tracheitis in children. Bronchoscopy aids diagnosis, secretion removal, and disease monitoring for effective airway management.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Critical Care Medicine
Background:
- Bacterial tracheitis is a severe upper airway infection in children.
- Management often requires airway support and close monitoring.
Purpose of the Study:
- To evaluate the safety and efficacy of nasotracheal intubation in pediatric bacterial tracheitis.
- To assess the role of fiberoptic bronchoscopy in managing this condition.
Main Methods:
- Retrospective review of 14 pediatric patients with bacterial tracheitis.
- Analysis of treatment protocols, including nasotracheal intubation and fiberoptic bronchoscopy.
- Identification of causative pathogens and patient outcomes.
Main Results:
- Nasotracheal intubation was used in 13 of 14 patients, with a mean duration of 7.6 days.
- Common pathogens included Staphylococcus aureus and Haemophilus influenzae.
- Fiberoptic bronchoscopy confirmed diagnosis, facilitated secretion removal, and monitored healing, with recovery noted 5-9 days post-symptom onset.
Conclusions:
- Nasotracheal intubation provides safe and effective airway management for pediatric bacterial tracheitis.
- Fiberoptic bronchoscopy is a valuable tool for diagnosis, treatment, and monitoring in bacterial tracheitis.
- Early signs of healing and clinical improvement guide extubation decisions.
Abstract:
We examined the records of 14 patients aged 7 months to 10 1/4 years who were treated for bacterial tracheitis from May 1982 to December 1987; the management protocol for 13 of the patients included the use of nasotracheal intubation. The infection was caused by Staphylococcus aureus in seven, Haemophilus influenzae in three, Branhamella catarrhalis in one and Streptococcus pneumoniae in one. Both H. influenzae and B. catarrhalis were isolated in another patient, and no organism was found in the remaining patient. In addition to the bacteria, viruses were cultured from the tracheal secretions of two patients. The mean duration of intubation was 7.6 days and of hospital stay 9.2 days. Twelve of the cases occurred during the cold months of the year (October to March). Of the three deaths only one occurred in the pediatric intensive care unit and was due to severe bronchospasm and an air leak that caused bilateral pneumothorax and pneumomediastinum. In one patient subglottic stenosis developed that necessitated tracheostomy. Healing began 5 to 9 days after the onset of symptoms, as demonstrated with the use of repeated fibreoptic bronchoscopy. We found that the airway could be safely managed with the use of a nasotracheal tube. Bronchoscopy helped to confirm the diagnosis, to remove adherent secretions and to monitor the course of the disease. The ventilation tube can be removed after the patient's temperature returns to normal, if there is an air leak around the tube, if the quantity and viscosity of the secretions decrease and if healing is observed at bronchoscopy.