Posted: July 28th, 2022
The Pathophysiology of Upper Airway Obstruction in Children
Upper airway obstruction can be defined as blockage or narrowing of the extrathoracic airway, thus hindering inspiration and expiration. Acute upper airway obstruction, especially in children, is a life-threatening emergency, and most children are presented in the outpatient with dyspnea and stridor. Complete obstruction of the airway results in respiratory failure, and the child can experience cardiac arrest any minute. Compared to adults, children have fewer airways, and obstruction results in tachycardia and difficulty breathing, and the child becomes irritable (Deflandre et al 2018).
There are various causes of upper airway obstruction, one of them being croup, which is infections in the airway causing swelling of the larynx; hence the child coughs and cannot breathe. The pathophysiology of the upper airway obstruction includes bacterial tracheitis whereby a child present with features of viral laryngotracheitis which causes the respiratory epithelium to slough and secrete large mucopurulent materials which block the trachea. Viral laryngotracheitis can also result in spasmodic croup, whereby a child gets inspiratory stridors, especially in the twilight hours. The most vulnerable children range from 6 months to four years.
Epiglottitis is another cause of airway obstruction, which presents with muffled voice, dysphagia, and drooling of saliva. Epiglottis has a sudden onset, and up to 8 hours after the infection, the airway is usually completely obstructed. The child tends to remain in an upright sitting position with his chin raised to gasp more air and complains of sore throat. Laryngeal papillomatosis is another cause of airway obstruction whereby benign wart growths are formed around the airway, causing obstructions. The peak age of this infection is between two to four years, and the children present with hoarsens and a change of voice. They develop a croupy cough (Heiser et al 2019).
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