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Upper Airway Obstruction

Upper Airway Obstruction. Upper Airway Obstruction. Potentially fatal Misdiagnosed as Asthma or COPD Multiple etiologies. Upper Airway Obstruction. Consists of the air conducting system Mouth Carina Divided by the thoracic inlet into extrathoracic & intrathoracic

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Upper Airway Obstruction

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  1. Upper Airway Obstruction

  2. Upper Airway Obstruction • Potentially fatal • Misdiagnosed as Asthma or COPD • Multiple etiologies

  3. Upper Airway Obstruction • Consists of the air conducting system Mouth Carina • Divided by the thoracic inlet into extrathoracic & intrathoracic • Extrathoracic Airway pharynx +larynx & extrathoracic trachea

  4. Upper Airway Obstruction • The extrathoracic trachea 2-4 cm intrathoracic trachea 9-12 cm • Caliber 13-25 mm men 10-21 mm women • Stridor indicate severe obstruction <5 mm but not the location of narrowing

  5. Upper Airway Obstruction Post intubation or Tracheostomy local edema ,ulceration & granuloma most resolve 8-12 weeks Closely related to Duration & Use High Pressure small volume cuff post extubation edema common in children

  6. Upper Airway Obstruction Inhalation Injury Could be gradual 2-12hours Mucosal edema increased secretions obstruction by the sloughed epithelium Fire , explosion in closed space Facial burns ,Hoarse voice Erythema oropharynx ? Effect of steroid

  7. Upper Airway Obstruction Foreign Body aspiration Common in children Adults with decreased LOC CNS diseases Drugs ETOH

  8. Upper Airway Obstruction Angioedema Hereditary C1 esterase deficiency IgE Mediated Non IgE Mediated (NSAID & ACEI ) Rx Epinepherine Steroids Antihistamines

  9. Upper Airway Obstruction Infections Croup children URTI viral infection Epiglotitis bacterial absence of cough & hoarseness of voice Ludwig's Angina cellulitis of mouth floor & submandibular area poor dentition Malignancy

  10. Upper Airway Obstruction Diagnosis CXR sometimes helpful Spirometry insensitive till advanced stage shape changes even before volumes CT define the location 3D reconstruction MRI superior estimating length & degree

  11. Upper Airway Obstruction Treatment Racemic Epi Croup vasoconstriction decreasing edema Steroids Croup & Post extubation ? Helium postextubation , tracheal stenosis extrinsic compression Lower density & viscosity Laser , Stenting & Dilatation

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