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Intensive care management of children intubated for croup: A retrospective analysis
Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary paedi...
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Published in: | Anaesthesia and intensive care 2016-03, Vol.44 (2), p.245-250 |
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creator | Gelbart, B. Parsons, S. Sarpal, A. Ninova, P. Butt, W. |
description | Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary paediatric intensive care units: Royal Children's Hospital Melbourne, Australia, and Alberta Children's Hospital, Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days. Patients less than 10 kg body weight were compared to those greater than 10 kg. Demographic, clinical and microbiological data were recorded. Seventy-seven cases of croup requiring intubation were identified. The median duration of intubation was 60 hours.'Parainfluenza' was the most common viral aetiology, detected in 30% of cases. Antibiotics were prescribed in 51% of patients. Corticosteroids were prescribed pre-intubation in two-thirds of patients and all post-intubation, with the median dose being prednisolone 3 mg/kg/day. Primary extubation failure occurred in 6.5% of patients. Neither the duration of intubation nor patient size were associated with extubation failure. An air leak test was performed in 69% of patients and poorly predicted extubation success. One non-urgent tracheostomy was performed and there was one death from hypoxic ischaemic encephalopathy. Endotracheal tube leak is poorly recorded and may not predict successful extubation. |
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We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary paediatric intensive care units: Royal Children's Hospital Melbourne, Australia, and Alberta Children's Hospital, Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days. Patients less than 10 kg body weight were compared to those greater than 10 kg. Demographic, clinical and microbiological data were recorded. Seventy-seven cases of croup requiring intubation were identified. The median duration of intubation was 60 hours.'Parainfluenza' was the most common viral aetiology, detected in 30% of cases. Antibiotics were prescribed in 51% of patients. Corticosteroids were prescribed pre-intubation in two-thirds of patients and all post-intubation, with the median dose being prednisolone 3 mg/kg/day. Primary extubation failure occurred in 6.5% of patients. Neither the duration of intubation nor patient size were associated with extubation failure. An air leak test was performed in 69% of patients and poorly predicted extubation success. One non-urgent tracheostomy was performed and there was one death from hypoxic ischaemic encephalopathy. Endotracheal tube leak is poorly recorded and may not predict successful extubation.</description><identifier>ISSN: 0310-057X</identifier><identifier>EISSN: 1448-0271</identifier><identifier>DOI: 10.1177/0310057X1604400211</identifier><identifier>PMID: 27029657</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adrenocortical hormones ; Airway (Medicine) ; Child, Preschool ; Critical Care ; Critical care medicine ; Croup ; Croup - therapy ; Evaluation ; Health services administration ; Humans ; Infant ; Intubation ; Intubation, Intratracheal ; Prednisolone - therapeutic use ; Retrospective Studies ; Trachea</subject><ispartof>Anaesthesia and intensive care, 2016-03, Vol.44 (2), p.245-250</ispartof><rights>2016 Australian Society of Anaesthetists</rights><rights>Copyright Australian Society of Anaesthetists Mar 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c496t-d9aa01be08d2f164e6fd9d0198f73e790acb9af2b823ffff054cbb180e9891cc3</citedby><cites>FETCH-LOGICAL-c496t-d9aa01be08d2f164e6fd9d0198f73e790acb9af2b823ffff054cbb180e9891cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27029657$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gelbart, B.</creatorcontrib><creatorcontrib>Parsons, S.</creatorcontrib><creatorcontrib>Sarpal, A.</creatorcontrib><creatorcontrib>Ninova, P.</creatorcontrib><creatorcontrib>Butt, W.</creatorcontrib><title>Intensive care management of children intubated for croup: A retrospective analysis</title><title>Anaesthesia and intensive care</title><addtitle>Anaesth Intensive Care</addtitle><description>Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary paediatric intensive care units: Royal Children's Hospital Melbourne, Australia, and Alberta Children's Hospital, Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days. Patients less than 10 kg body weight were compared to those greater than 10 kg. Demographic, clinical and microbiological data were recorded. Seventy-seven cases of croup requiring intubation were identified. The median duration of intubation was 60 hours.'Parainfluenza' was the most common viral aetiology, detected in 30% of cases. Antibiotics were prescribed in 51% of patients. Corticosteroids were prescribed pre-intubation in two-thirds of patients and all post-intubation, with the median dose being prednisolone 3 mg/kg/day. Primary extubation failure occurred in 6.5% of patients. Neither the duration of intubation nor patient size were associated with extubation failure. An air leak test was performed in 69% of patients and poorly predicted extubation success. One non-urgent tracheostomy was performed and there was one death from hypoxic ischaemic encephalopathy. Endotracheal tube leak is poorly recorded and may not predict successful extubation.</description><subject>Adrenocortical hormones</subject><subject>Airway (Medicine)</subject><subject>Child, Preschool</subject><subject>Critical Care</subject><subject>Critical care medicine</subject><subject>Croup</subject><subject>Croup - therapy</subject><subject>Evaluation</subject><subject>Health services administration</subject><subject>Humans</subject><subject>Infant</subject><subject>Intubation</subject><subject>Intubation, Intratracheal</subject><subject>Prednisolone - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Trachea</subject><issn>0310-057X</issn><issn>1448-0271</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9kU1rFTEUhoNY7LX6B1zIgBs3Y08-Jh_uSlFbKHShQnchkznTzmVmck0yhf57M73VioVmk0We983JE0LeUfhEqVLHwClAo66oBCEAGKUvyIYKoWtgir4kmxWoV-KQvE5pC0ANU80rcsgUMCMbtSHfz-eMcxpusfIuYjW52V3jhHOuQl_5m2HsIs7VMOeldRm7qg-x8jEsu8_VSRUxx5B26PNaUKLjXRrSG3LQuzHh24f9iPz8-uXH6Vl9cfnt_PTkovbCyFx3xjmgLYLuWE-lQNl3pisz6l5xVAacb43rWasZ78uCRvi2pRrQaEO950fk4753F8OvBVO205A8jqObMSzJFkfKaClBFvTDf-g2LLHMe09JSbWQvFBsT5UHphSxt7s4TC7eWQp2VW6fKi-h9w_VSzth9zfyx3EBjvdAKmb_ufe5yqt9Ik5Dtj6M42o4zGnrcrIJXfQ3dpjLV6znIV7bLgzWtfelnFP5eCiAlX6qFWsY15z_BsDKqLo</recordid><startdate>20160301</startdate><enddate>20160301</enddate><creator>Gelbart, B.</creator><creator>Parsons, S.</creator><creator>Sarpal, A.</creator><creator>Ninova, P.</creator><creator>Butt, W.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AYAGU</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20160301</creationdate><title>Intensive care management of children intubated for croup: A retrospective analysis</title><author>Gelbart, B. ; 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source | Alma/SFX Local Collection; SAGE |
subjects | Adrenocortical hormones Airway (Medicine) Child, Preschool Critical Care Critical care medicine Croup Croup - therapy Evaluation Health services administration Humans Infant Intubation Intubation, Intratracheal Prednisolone - therapeutic use Retrospective Studies Trachea |
title | Intensive care management of children intubated for croup: A retrospective analysis |
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