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February 1983

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

Author Affiliations

From the Division of Respiratory Physiology, Research Institute, The Hospital for Sick Children, University of Toronto. Dr Newth is now with Moffitt Hospital, San Francisco.

Am J Dis Child. 1983;137(2):139-141. doi:10.1001/archpedi.1983.02140280037010

• 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)