pediatric postintubation stridor

[Neogenesis]

---

Members do not see this ad.

Anybody have good experience with postintubation stridor/croup in peds pts. In particular, how long can it last? Is it feasible to wax and wane? Had a case with 8 wk old who appeared to develop it following surgery, resolved overnight (no racemic epi required). Is it possible to still be present/exacerbate in the following 24-48h?

Any discussions appreciated.

NEO

 

[somedumbDO]

Yup

 

[deleted9493]

It would be unusual to see it exacerbate after 24hrs. I have seen exacerbation of stridor after 3-4hrs from extubation, regardless of whether or not leak was confirmed and cuff pressure minimized intraoperatively. More often than not its been after longer cases and those involving more fluid administration...not surprisingly.

Yes, to your question--"can it persist beyond 1-2 days?". Most definitely.

 

[michigangirl]

It can persist for 24-48 hours post, but should not get worse over time, should peak in the first 24 hours and kid should otherwise be themselves (outside of whatever surgical pain they are experiencing). Usually its most painful for the parents to listen to, the kids actually are fine. If there is fever or kids not themselves, all bets are off, if they are at home they need to go to be seen.

 

[urge]

My lit search wasn't very fruitful as for duration. My gut feeling is that it shouldn't last more than 3 days. I would get ENT involved if it did. I would be concerned about granulation tissue obstructing the airway.