Clinical Study of Aggressive Airway Management of Acute Epiglottitis in Adults

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IntroductionWe examined how to choice the methods of choosing aggressive airway managements of adult acute epiglottitis.Materials and MethodsA retrospective survey was conducted on 290 cases of epiglottitis admitted to Kitasato University Hospital during the period from July 1971 to January 2005. Eighteen adults cases of the 290 underwent aggressive procedures on admission to maintain an open airway.ResultsTracheotomy was performed in 10 cases, tracheal intubation in 6 cases, cricothyrotomy in 1 case, and percutaneous cricothyrotomy in 1 case.Conclusion1. When an experienced otolaryngologist is in the operation room and where an anesthesiologist is on standby, it is safest to perform tracheotomy.2. When there is not time to establish an airway by tracheotomy, an airway should be established by cricothyrotomy, percutaneous cricothyrotomy or mask ventilation.3. Tracheal intubation should be performed only in cases of unconsciousness or respiratory arrest.4. When performing tracheal intubation in a patient who is conscious, it should be performed in the operation room where equipment is prepared. When performing tracheal intubation in the ward, we should prepare to be able to also perform tracheotomy or cricothyrotomy, or percutaneous cricothyrotomy.