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Pediatric Stridor

Anne Hseu, Mykayla Sandler, Dawn Ericson, Nohamin Ayele, Kosuke Kawai, Roger Nuss
INTRODUCTION: Although dyspnea with exercise in the pediatric population can be multifactorial, the diagnosis of paradoxical vocal fold motion disorder (PVFMD) in this group is not well characterized. The objective of this study is to review the multiple causes of dyspnea with exercise in children, including the prevalence of PVFMD within this study population. METHODS: A retrospective review was conducted of patients seen at a tertiary pediatric hospital for exercise-induced dyspnea suspected to be related to PVFMD between January 2007 and July 2015...
November 2016: International Journal of Pediatric Otorhinolaryngology
Rekha Krishnasarma, Liza Green Golan Mackintosh, Francine Bynum
Many children who are admitted to pediatric hospitals with the chief complaint of apparent life-threatening event (ALTE) are, in fact, well appearing by the time the inpatient medical team evaluates the patient. This presents a diagnostic and therapeutic challenge. We describe a case of a six-month-old full-term female presenting with an ALTE and found to have a double aortic arch, a congenital anomaly that usually presents with a more progressive onset of symptoms such as chronic cough, positional stridor, and feeding difficulties...
2016: Case Reports in Pediatrics
Jennifer C DeMichele, Nikhil Vajaria, Hongyue Wang, Dawn M Sweeney, Karen S Powers, Jill M Cholette
STUDY OBJECTIVE: To determine the incidence of postoperative airway complications in infants <5kg in weight undergoing cardiac surgery intubated with Microcuff (Kimberley-Clark, Roswell, GA) endotracheal tubes (ETTs). DESIGN: Retrospective review of infants weighing <5.0 kg with congenital heart disease (CHD) presenting for cardiac surgery. SETTING: Single-center, tertiary pediatric cardiac critical care unit at a university hospital...
September 2016: Journal of Clinical Anesthesia
Madhankumar Sathyamoorthy, Jerrold Lerman, Victoria I Okhomina, Alan D Penman
STUDY OBJECTIVE: This study aimed to characterize the current practice patterns with cuffed tracheal tubes (CTT) in neonates, infants, and children among members of the Society of Pediatric Anesthesia (SPA). DESIGN AND SETTING: An electronic mail survey was distributed using Survey Monkey to members of SPA between December 2013 and February 2014. Each member was permitted one response. PATIENTS/INTERVENTION/MEASUREMENTS: Not applicable as this is a practice survey study...
September 2016: Journal of Clinical Anesthesia
Jose Carlos Fraga, Russell W Jennings, Peter C W Kim
Tracheomalacia (TM) is defined as an increased collapsibility of the trachea due to structural anomalies of the tracheal cartilage and/or posterior membrane. Tracheomalacia has a wide range of etiologies but is most commonly present in children born with esophageal atresia and tracheal esophageal fistula. Clinical symptoms can range from minor expiratory stridor with typical barking cough to severe respiratory distress episodes to acute life-threatening events (ALTE). Although the majority of children have mild-to-moderate symptoms and will not need surgical intervention, some will need life-changing surgical treatment...
June 2016: Seminars in Pediatric Surgery
Inderpaul Singh Sehgal, Sahajal Dhooria, Amanjit Bal, Ashutosh N Aggarwal, Digambar Behera, Ritesh Agarwal
Obstructive fibrinous tracheal pseudomembrane (OFTP) is an uncommon complication that results after tracheal intubation. Herein, we perform a systematic review of the PubMed and EmBase databases for all the cases describing OFTP. The systematic search yielded 28 citations describing 53 subjects with OFTP. The study population (61.1% females) comprised of both adults and pediatric subjects with a median (IQR) age of 40.5 (14.8-60.5) years. The median (IQR) size of endotracheal tube was 7.5 (6-9.3) mm with a median (IQR) duration of intubation of 36 (14-96) hours...
September 2016: Respiratory Care
Bhartendu Bharti, Kamran Asif Syed, Kala Ebenezer, Ajoy Mathew Varghese, Mary Kurien
STUDY OBJECTIVES: To identify acute laryngeal injuries among pediatric patients intubated for more than 48hours, and to correlate these injuries with clinical variables. SETTING: Pediatric Intensive Care Unit (PICU) of a tertiary level hospital in India. PATIENTS AND METHODS: Prospective, observational study. Thirty-four children meeting the inclusion and exclusion criteria were recruited into the study after obtaining informed consent from the parents...
June 2016: International Journal of Pediatric Otorhinolaryngology
Mohamad Ahmad Bitar, Randa Al Barazi, Rana Barakeh
INTRODUCTION: The management of laryngotracheal stenosis is complex and is influenced by multiple factors that can affect the ultimate outcome. Advanced lesions represent a special challenge to the treating surgeon to find the best remedying technique. OBJECTIVE: To review the efficacy of our surgical reconstructive approach in managing advanced-stage laryngotracheal stenosis treated at a tertiary medical center. METHODS: A retrospective review of all patients that underwent open laryngotracheal repair/reconstruction by the senior author between 2002 and 2014...
April 27, 2016: Brazilian Journal of Otorhinolaryngology
Candice L Bjornson, Janielee Williamson, David W Johnson
OBJECTIVE: The objective was to derive a simple clinical scoring instrument for assessing children with croup by telephone for use in clinical research studies. METHODS: We reviewed published literature on croup scores, surveyed experienced pediatric emergency nurses and physicians, and conducted a prospective cohort study. Score items were derived from published literature and surveys of experienced clinicians. We enrolled children with croup attending an urban pediatric emergency department...
May 2016: Pediatric Emergency Care
John Carter, Reza Rahbar, Matthew Brigger, Kenny Chan, Alan Cheng, Sam J Daniel, Alessandro De Alarcon, Noel Garabedian, Catherine Hart, Christopher Hartnick, Ian Jacobs, Bryan Liming, Richard Nicollas, Seth Pransky, Gresham Richter, John Russell, Michael J Rutter, Anne Schilder, Richard J H Smith, Julie Strychowsky, Robert Ward, Karen Watters, Michelle Wyatt, George Zalzal, Karen Zur, Dana Thompson
OBJECTIVE: To provide recommendations for the comprehensive management of young infants who present with signs or symptoms concerning for laryngomalacia. METHODS: Expert opinion by the members of the International Pediatric Otolaryngology Group (IPOG). RESULTS: Consensus recommendations include initial care and triage recommendations for health care providers who commonly evaluate young infants with noisy breathing. The consensus statement also provides comprehensive care recommendations for otolaryngologists who manage young infants with laryngomalacia including: evaluation and treatment considerations for commonly debated issues in laryngomalacia, initial work-up of infants presenting with inspiratory stridor, treatment recommendations based on disease severity, management of the infant with feeding difficulties, post-surgical treatment management recommendations, and suggestions for acid suppression therapy...
July 2016: International Journal of Pediatric Otorhinolaryngology
S Mukhopadhyay, S Mukhopadhyay, D Bhattacharya, B K Bandyopadhyay, M Mukherjee, R Ganguly
BACKGROUND: Uncuffed endotracheal tubes are commonly used in children but due to several decade preferred in paediatric oral surgery. Due to lack of conclusive evidences in this regard, we have conducted this study to compare post-operative morbidity following use of cuffed and uncuffed endotracheal tubes in paediatric patients undergoing cleft lip-palate surgery. METHODS: This randomised controlled trial was conducted on children aged 2 to 12 years.110 patients were allocated in two parallel groups using computer generated list of random numbers...
April 2016: Saudi Journal of Anaesthesia
Kyra Schmidt, Andres Leal, Thomas McGill, Roy Jacob
Up to 20% of all congenital pediatric head and neck masses are branchial cleft cysts. Second branchial cleft cysts account for 95% of branchial anomalies, and fourth branchial cleft cysts are the rarest type. Their typical presentations include non-life-threatening symptoms, such as drainage, skin irritations, minor swelling, and tenderness. We describe a 5-week-old neonate with increasing stridor secondary to a rapidly growing neck mass. Imaging and surgical excision confirmed the mass to be an infected fourth branchial cleft cyst...
April 2016: Proceedings of the Baylor University Medical Center
Jenna O Miller, Satid Thammasitboon, Deborah C Hsu, Manish I Shah, Charles G Minard, Jeanine M Graf
OBJECTIVE: Research has shown that patients transported by nonpediatric teams have higher rates of morbidity and mortality. There is currently a paucity of pediatric standardized ongoing medical education for emergency medical service providers, thus we aimed to develop a model curriculum to increase their knowledge regarding pediatric respiratory distress and failure. METHODS: The curriculum was based on the Kolb Learning Cycle to optimize learning. Target learners were flight nurses (registered nurse) and emergency medical technicians of a private helicopter emergency transport team...
February 2016: Pediatric Emergency Care
Behera Ganakalyan, Samal Dilllip Kumar
INTRODUCTION: Fibrolipoma, a subtype of lipoma is painless, well-circumscribed, slow-growing, submucosal benign adipocyte tumour. It is uncommon in the oral cavity and oropharyngeal region, with rare incidence in the retropharynx even rarest in pediatric age group. CASE REPORT: A very unusual case of fibrolipoma is presented in a pediatric patient, who had a huge retropharyngeal fibrolipoma and who presented with breathing difficulty and increasing stridor. It was managed by intro-oral approach excision...
November 2015: Iranian Journal of Otorhinolaryngology
Yi Qian, Zhengde Xie, Lili Ren, Chunyan Liu, Yan Xiao, Baoping Xu, Yan Yang, Suyun Qian, Rong Geng, Kunling Shen
OBJECTIVE: To investigate human coronaviruses (HCoVs) infection in children with acute lower respiratory tract infection(ALRTI)and to explore the clinical features of ALRTI caused by HCoVs in children. METHOD: Totally 4 371 children with clinical diagnosis of ALRTI during the period from March 2007 to February 2015 seen in Beijing Children's Hospital were recruited into this study. Patients were divided into 4 groups by age, including 1 890 cases in < 1 year group, 788 cases in 1-3 years group, 553 cases in 3-6 years group, 1140 cases in ≥6 years group...
September 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Raylene Dias, Chandrahas T Deshmukh, Milind S Tullu, Chhaya Divecha, Sunil Karande
Laryngomalacia is a common cause of respiratory obstruction with stridor in infants. Although most cases resolve spontaneously, severe laryngomalacia needs surgical intervention. Tracheostomies have been the mainstay of treatment. However, this procedure was associated with high morbidity. At present, newer modalities of treatment are being tried. We discuss successful management of an infant having severe laryngomalacia (who had three failed extubation trials) with glossoepiglottopexy.
November 2015: Indian Journal of Critical Care Medicine
Naho Obayashi, Mitsuyoshi Suzuki, Tomoaki Yokokura, Nakayuki Naritaka, Satoshi Nakano, Yoshikazu Ohtsuka, Hiroyuki Sugo, Seiji Kawasaki, Toshiaki Shimizu
Increasingly, food allergy associated with tacrolimus after pediatric living-donor liver transplantation (LT) has been reported. Tacrolimus prevents the activation of T cells by blocking calcineurin, thus producing an immunosuppressive effect, but tacrolimus induces an imbalance in T-helper type 1 (Th1) and Th2 cells in the food allergy process. This report describes a case of tacrolimus-associated food allergy after pediatric living-donor LT. The patient was a 7-year-old Japanese girl who had undergone living-donor LT at 12 months of age, and whom we first saw in the clinic at age 18 months...
December 2015: Pediatrics International: Official Journal of the Japan Pediatric Society
Mi Jin Yoo, Soham Roy, Lee P Smith
INTRODUCTION: Congenital anterior glottic stenosis (web) is a rare condition usually presenting with airway obstruction, stridor or dysphonia. Symptomatic infants may require tracheotomy to bridge the neonatal period. Early open surgical reconstruction may have significant risks and failure may still result in tracheotomy. We introduce an endoscopic surgical approach with balloon dilation for primary management of congenital anterior glottic stenosis. METHODS: We present three cases of congenital anterior glottic stenosis in children 7, 14, and 90 days old presenting with stridor, dyspnea, and dysphonia...
December 2015: International Journal of Pediatric Otorhinolaryngology
Robinder G Khemani, Justin Hotz, Rica Morzov, Rutger Flink, Asavari Kamerkar, Patrick A Ross, Christopher J L Newth
RATIONALE: Subglottic edema is the most common cause of pediatric extubation failure, but few studies have confirmed risk factors or prevention strategies. This may be due to subjective assessment of stridor or inability to differentiate supraglottic from subglottic disease. OBJECTIVES: Objective 1 was to assess the utility of calibrated respiratory inductance plethysmography (RIP) and esophageal manometry to identify clinically significant post-extubation upper airway obstruction (UAO) and differentiate subglottic from supraglottic UAO...
January 15, 2016: American Journal of Respiratory and Critical Care Medicine
Anirban Mandal, Sushil K Kabra, Rakesh Lodha
Children with upper airway obstruction are both unique and variable in their presentation and management, often posing a challenge to the pediatrician. Several anatomical and physiologic peculiarities make a child vulnerable to develop an obstruction of upper airways. The characteristic finding in upper airway obstruction is stridor-inspiratory, biphasic or expiratory. The etiologies vary widely throughout the age groups and according to the mode of presentation. The approach starts with suspicion, mandates careful clinical evaluation of the degree of obstruction and many a times emergency measures precede any investigation or even precise diagnosis...
August 2015: Indian Journal of Pediatrics
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