Thyroidectomy is the treatment of choice in patients with thyroid enlargement complicated by compression or displacement of the trachea because of the risk of complete airway obstruction due to sudden enlargement of the goitre by, for example, haemorrhage. In patients who are medically inoperable an endoscopically inserted tracheal endoprosthesis may provide longstanding airway patency, as repo...

Airway inflammation and remodelling play an important role in the pathophysiology of asthma. Remodelling may affect childhood lung function, and this process may be reversed by anti-inflammatory treatment. The current study assessed longitudinally whether asthma affects growth of airway function relative to airspaces, and if so whether this is redressed by inhaled corticosteroids (ICS). Every 4...

Smoke inhalation injury, a unique form of acute lung injury, greatly increases the occurrence of postburn morbidity and mortality. In addition to early intubation for upper-airway protection, subsequent critical care of patients who have this injury should be directed at maintaining distal airway patency. High-frequency ventilation, inhaled heparin, and aggressive pulmonary toilet are among the...

During sedation and recovery the airway of children with obstructive sleep apnea is vulnerable to collapse. This vulnerability arises from both an inherent collapsibility of the pharyngeal airway in these children and a heightened sensitivity to sedative and anesthetic agents. Pharmacologic and nonpharmacologic support may be required to defend pharyngeal airway patency in children with obstruc...

The obstructive sleep apnea syndrome (OSAS) is a common and serious condition during childhood. Its pathophysiology remains poorly understood. Although OSAS is related to adenotonsillar hypertrophy in children, adenotonsillar hypertrophy is not likely the sole cause of sleep-disordered breathing in this age group. Rather, large tonsils and adenoids appear to precipitate OSAS in children with un...

Airway management is one of the key aspects of neonatal anesthesia, and an oropharyngeal airway is used in daily intensive care practice to relieve upper-airway obstruction. Cleft palate is among the various congenital malformations that can cause difficult airway management. We describe a syndromic infant with alobar holoprosencephaly, whose long-term airway patency was maintained with a modif...

High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. This case report describes spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen to succes...

The airway narrowing in chronic obstructive pulmonary disease (COPD) has often been misunderstood as being irreversible. However, a large proportion of patients with COPD do respond to bronchodilator agents with significant changes in lung function. Unlike in asthma, abnormalities in airway smooth muscle structure or function are not believed to play a key role in COPD airway narrowing. Althoug...

Maintenance of a patent airway is the most important aspect of the safe administration of anesthesia in children. However, in spontaneously breathing, anesthetized children, upper airway obstruction is a frequent problem (1) and failure to maintain a patent airway can rapidly result in hypoxemia, bradycardia or even cardiac arrest. Upper airway narrowing is most likely to appear in pharyngeal s...

Pulmonary surfactant maintains patency of narrow conducting airways. An inflammation, with a leakage of plasma proteins into the airway lumen, causes surfactant to lose some of this ability. Will a lowering of temperature aggravate the deteriorating effect of an inflammation? Calf lung surfactant extract (CLSE) with proteins added was studied with a capillary surfactometer (CS) at temperatures ...