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Respiratory Status of Children With Epiglottitis With and Without an Artificial Airway

D. Colm Costigan, MB, FRCP(C); Christopher J. L. Newth, MB, FRCP(C)
Am J Dis Child. 1983;137(2):139-141. doi:10.1001/archpedi.1983.02140280037010.
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• During a ten-year period, 22 children from our 170 cases of acute epiglottitis had reliable records of arterial blood gas data. The arterial/alveolar (a/A) oxygen tension ratios were calculated, with a value less than 0.75 representing abnormal gas exchange. The mean a/A ratio for the whole group, 17 of whom already had an artificial airway, was 0.59 (range, 0.29 to 0.83). A subgroup of five children with blood samples taken during conservative treatment or before airway insertion had a mean a/A ratio of 0.62 (range, 0.49 to 0.77) without hypercapnia (mean Paco2, 32 mm Hg; range, 29 to 39 mm Hg), which seemed to be a late feature. Thirty-three percent of initial chest roentgenograms were abnormal, with the major disorder being atelectasis and/or consolidation. We propose that the radiologic and gas exchange abnormalities result from the common pathophysiologic mechanism of increased lung water.

(Am J Dis Child 1983;137:139-141)


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