Nasotracheal Intubation in Acute Epiglottiditis

Abstract

Twenty children, from 1 to 6 years of age, with typical acute epiglottiditis were treated, not by tracheotomy, but by nasotracheal intubation using smooth, polyvinylchloride tubes. The rapid course and progression of the disease is stressed. Ten children had to be intubated immediately and the remainder a few hours after admission. The mean intubation period was 39 hours, 8 and 83 hours the extremes. The tube was well tolerated, and only a few, negligible symptoms occurred after extubation. Since the great majority of the children have to be intubated in order to be tracheotomized, and since the critical period for airway obstruction in acute epiglottiditis is at most 48 hours, nasotracheal intubation is preferable to acute tracheotomy in a severely ill child.