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Acute epiglottitis: intubation versus tracheostomy.

R W Cantrell, R A Bell, W T Morioka

    The Laryngoscope
    |June 1, 1978
    PubMed
    Summary
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    Acute epiglottitis in children requires prompt airway management. Tracheostomy or endotracheal intubation offer similar low mortality rates, unlike medical management alone.

    Area of Science:

    • Pediatrics
    • Otolaryngology
    • Emergency Medicine

    Background:

    • Acute epiglottitis is a life-threatening condition in children.
    • It can rapidly lead to respiratory arrest due to supraglottic swelling.
    • Early diagnosis and airway intervention are crucial for survival.

    Purpose of the Study:

    • To compare the mortality rates of different airway management strategies for acute epiglottitis.
    • To evaluate the effectiveness of tracheostomy versus endotracheal intubation.
    • To assess the risks associated with medical management without an artificial airway.

    Main Methods:

    • A review of 19 series encompassing 738 cases of epiglottitis, supplemented by 11 new cases.
    • Analysis of treatment outcomes based on airway management: tracheostomy, endotracheal intubation, or medical management.

    Related Experiment Videos

  • Comparison of mortality data across the different treatment groups.

    • Main Results:

    • Tracheostomy group (348 patients): 3 deaths (0.86% mortality).
    • Endotracheal intubation group (216 patients): 2 deaths (0.92% mortality).
    • Medical management without an artificial airway group (214 patients): 13 deaths (6.1% mortality).

    Conclusions:

    • Tracheostomy and endotracheal intubation demonstrate comparable and low mortality rates for acute epiglottitis.
    • Medical management without securing an airway is associated with significantly higher mortality in pediatric cases.
    • The choice between tracheostomy and endotracheal intubation should be based on local resources and expertise.