Acute and chronic airway obstruction in children |
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| Authors: | Gary M. Doherty |
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| Affiliation: | 1. Laboratory of Anatomy-Histology-Embryology, School of Medicine, University of Crete, Heraklion, Greece;2. Department of Forensic Sciences and Toxicology, University of Crete, Heraklion, Greece;3. Laboratory of Toxicology, DiSFeB, Università degli Studi di Milano, Italy;1. Division of Neonatology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA;2. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA;3. Departments of Pathology and Pediatrics, Emory University School of Medicine, Atlanta, GA;4. Department of Pathology, Children''s Healthcare of Atlanta Blood and Tissue Services, Atlanta, GA;5. Division of Neonatology, Department of Pediatrics, University of Texas, Southwestern, Dallas, TX;1. Service de néonatologie et réanimation néonatale, CHU de Hassan II, Fès, Maroc;2. Université Sidi-Mohamed-Ben-Abdellah, Fès, Maroc;1. National TCM Key Lab of Serum Pharmacochemistry, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China;2. Institute of Natural Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan;3. Harbin Children''s Hospital, Youyi Road 57, Harbin, China;4. School of Pharmacy, Health Science Center, Xi’an Jiaotong University, Shaanxi 710061, China;1. Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Global COE “Cell Fate Regulation Research and Education Unit”, Kumamoto University, Kumamoto 862-0973, Japan;2. The Japan Society for the Promotion of Science (JSPS), Tokyo 102-8472, Japan;3. Laboratory of Pharmacology, Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto 860-0082, Japan;4. Department of Otolaryngology - Head and Neck Surgery, San Francisco, San Francisco, CA 94115, USA;5. Department of Laboratory Medicine, San Francisco, San Francisco, CA 94115, USA;6. Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, San Francisco, San Francisco, CA 94115, USA;7. Helen Diller Family Comprehensive Cancer Center, San Francisco, San Francisco, CA 94115, USA;8. Institute for Human Genetics, San Francisco, San Francisco, CA 94115, USA;9. Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94115, USA;10. Department of Pediatrics, University of Vermont College of Medicine, Burlington, VT 05405, USA |
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| Abstract: | Airway obstruction is more common in children than in adults. This is because of subtle anatomical differences in the childhood airway and an increased propensity to infection. Effects of obstruction manifest more quickly in children because of a smaller airway diameter, reduced physiological reserve and easily fatigued respiratory muscles. The anaesthetist may encounter airway obstruction in children both outside and within the operating theatre. Problems can be either anticipated or unexpected. The anaesthetist must be able to recognize risk factors for airway obstruction such as a history of respiratory symptoms, including sleep-disordered breathing, and high-risk groups, such as ex-preterm infants. An understanding of the pathophysiology of airway obstruction can help in the recognition, diagnosis and appropriate management of airway obstruction. The pathophysiology of airway obstruction is intimately linked with the anatomy and mechanics of the upper airway and the tracheobronchial tree. The pathophysiology of airway obstruction is reviewed and this knowledge applied to problems occurring inside and outside the operating theatre, including both anticipated and unexpected problems. |
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