Stridor

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Treatments

• Expectant management with full monitoring, oxygen by face mask, and positioning the head of the bed for optimum conditions (e.g., 45 - 90 degrees)

• Use of nebulized
  Nebulizer
  
  In medicine, a nebulizer is a device used to administer medication to people in the form of a mist inhaled into the lungs. It is commonly used in treating cystic fibrosis, asthma, and other respiratory diseases....
   racemic
  Racemic
  
  In chemistry, a racemic mixture, or racemate, is one that has equal Amount of substance of left- and right-handed enantiomer of a Chirality molecule....
   adrenaline (0.5 to 0.75 ml of 2.25% racemic adrenaline added to 2.5 to 3 ml of normal saline) in cases where airway oedema may be the cause of the stridor. ( Nebulized Cocaine
  Cocaine
  
  Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine....
   in a dose not exceeding 3 mg/kg may also be used, but not together with racemic adrenaline [because of the risk of ventricular arrhythmias].)

• Use of dexamethasone
  Dexamethasone
  
  Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid hormones. It acts as an anti-inflammatory and immunosuppressive drug....
   (Decadron) 4-8 mg IV q 8 - 12 h in cases where airway oedema may be the cause of the stridor; note that some time (in the range of hours) may be need for dexamethasone to work fully.

• Use of inhaled Heliox
  Heliox
  
  Heliox is a breathing gas composed of a mixture of helium and oxygen .Heliox has been used medically since the 1930s, and although the medical community adopted it initially to alleviate symptoms of upper airway obstruction, its range of medical uses has since expanded greatly, mostly because of the low density of the gas....
   (70% helium
  Helium
  
  Helium is a colorless, odorless, tasteless, non-toxic, inert monatomic chemical element that heads the noble gas group in the periodic table and whose atomic number is 2....
  , 30% oxygen
  Oxygen
  
  Oxygen no O2 produced; 2) O2 produced, but absorbed in oceans & seabed rock; 3) O2 starts to gas out of the oceans, but is absorbed by land surfaces and formation of ozone layer; 4-5) O2 sinks filled and the gas accumulates]]...
  ); the effect is almost instantaneous. Helium, being a less dense gas than nitrogen, reduces turbulent flow through the airways.

Causes

• foreign bodies (e.g., aspirated
  Pulmonary aspiration
  
  In medicine, aspiration is the entry of secretions or foreign material into the Vertebrate trachea and lungs.The patient may either inhalation the material, or it may be blown into the lungs during positive pressure ventilation or CPR....
   peanut
  Peanut
  
  The peanut, or groundnut , is a species in the legume Fabaceae native to South America, Mexico and Central America. It is an annual plant herbaceous plant growing to 30 to 50 cm tall....
  , aspirated wire),
• tumor formation (e.g., laryngeal papillomatosis, squamous cell carcinoma
  Squamous cell carcinoma
  
  In medicine, squamous cell carcinoma is a form of cancer of the carcinoma type that may occur in many different organs, including the skin, lips, mouth, esophagus, urinary bladder, prostate, lungs, vagina, and cervix....
  ),
• infections (e.g., epiglottitis
  Epiglottitis
  
  Epiglottitis is inflammation of the epiglottis - the flap that sits at the base of the tongue, which keeps food from going into the trachea . Due to its place in the airway, swelling of this structure can interfere with Breath and constitutes a medical emergency....
  , retropharyngeal abscess, croup
  Croup
  
  Croup is a group of respiratory diseases that often affects infants and children under age 6. It is characterized by a barking cough; a whistling, obstructive sound as the child breathes in; and hoarseness due to obstruction in the region of the larynx....
  ),
• subglottic stenosis
  Stenosis
  
  A stenosis is an abnormal narrowing in a blood vessel or other tubular Organ or structure.It is also sometimes called a "stricture" .The term "coarctation" is synonymous, but is commonly used only in the context of aortic coarctation....
   (e.g., following prolonged intubation or congenital),
• airway edema (e.g., following instrumentation of the airway intubation
  Intubation
  
  In medicine, intubation refers to the placement of a tube into an external or internal orifice of the body. Although the term can refer to endoscopy procedures, it is most often used to denote tracheal intubation....
  , drug side effect, allergic reaction),
• as well as a result of laryngomalacia
  Laryngomalacia
  
  Laryngomalacia is a very common condition of infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction....
   (the most common congenital cause of stridor),
• subglottic hemangioma
  Hemangioma
  
  A hemangioma is a congenital benign tumour or vascular malformation of endothelial cells .In infancy, it is the most common tumor....
   (rare),
• and vascular rings compressing the trachea.
• Abnormalities of vocal cord function can also be responsible.
• Congenital anomalies of the airway are present in 87% of all cases of stridor in infants and children.

Diagnosis

External links