Acute epiglottitis: management by short duration of intubation and hospitalisation

One hundred and thirty-seven patients with acute epiglottitis were studied retrospectively with regard to the efficacy and safety of short duration of intubation and hospitalisation. All patients were treated by nasotracheal intubation and antibiotic therapy. Inhalation anesthesia with halothane/oxygen was the preferred method for intubation (80.3%). Extubation was based on clinical improvement in 88.1% and on laryngoscopy in 11.9% of cases. Fifty-four percent of the patients were extubated successfully within 24 h and 94.8% within 48 h. Three patients (2.2%) had to be reintubated once. The mean duration of intubation was 27.6 h (range 8-86) and of hospitalisation 4.0 days (range 2-9). Two children (1.5%) died because of severe hypoxic brain damage due to cardiorespiratory arrest prior to hospital admission. A follow-up study conducted via the family physician revealed only two major complications (granulation polyp of the vocal cords, 1; long-lasting hoarseness, 1). It is concluded that short duration of intubation and hospitalisation are effective and safe in the management of acute epiglottitis.