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Continuing Education in Anaesthesia, Critical Care & Pain 2007 7(6):183-186; doi:10.1093/bjaceaccp/mkm041
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© The Board of Management and Trustees of the British Journal of Anaesthesia [2007]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Acute stridor in children

Emma Maloney, BM BCh BA FRCA, Clinical Fellow in Paediatric Anaesthesia and George H. Meakin, MD FRCA, Senior Lecturer in Paediatric Anaesthesia
Royal Manchester Children's Hospital
Pendlebury
Manchester M27 4HA
UK
Royal Manchester Children's Hospital
Pendlebury
Manchester M27 4HA
UK
Tel: +44 161 992 2291 Fax: +44 161 992 2439 E-mail: george.meakin@manchester.ac.uk

Key Words: Stridor is a harsh, vibratory sound produced when the airway becomes partially obstructed, resulting in turbulent flow. • Several anatomical and physiological features of the respiratory system in young children render them susceptible to airway obstruction. • Children with symptoms and signs of severe airway obstruction require urgent examination of the airway under anaesthesia to determine the cause and secure the airway. • Viral croup (laryngotracheobronchitis) is responsible for more than 80% of cases of acute stridor in children. • Since the introduction of Haemophilus influenzae type b vaccine, childhood epiglottis has become rare, making recognition and management more challenging.

The first 150 words of the full text of this article appear below.

Stridor is a harsh, vibratory sound produced when the airway becomes partially obstructed, resulting in turbulent airflow in the respiratory passages. It is symptomatic of underlying pathology and may herald life-threatening airway obstruction. This article reviews the assessment, common causes, and treatment of a child with a previously normal airway presenting with acute stridor.


   Anatomy and physiology
 
Several anatomical and physiological features of the respiratory system in infants (age <1 yr) and young children render them susceptible to airway obstruction. The upper and lower airways are small, prone to occlusion by secretions, and susceptible to oedema and swelling. As resistance to laminar airflow increases in inverse proportion to the fourth power of the radius (Poiseuille's law), a small decrease in the radius of the airway results in a marked increase in resistance to airflow and the work of breathing.

The support components of the airway are less developed and more compliant than in . . . [Full Text of this Article]


   Assessment
 

   Viral croup
 

   Postintubation croup
 

   Epiglottitis
 

   Bacterial tracheitis
 

   Retropharyngeal or tonsillar abscess
 

   Foreign body aspiration
 

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