Pediatr Allergy Respir Dis.  2005 Mar;15(1):61-71.

Etiologies and Clinical Courses of Stridor with Respiratory Distress of Non-infectious Origin in Infants and Children

• Park SH
• Ko JY
• Park HY
• Ann KM
• Son YI
• Lee SI

Abstract

PURPOSE
The aim of this study was to investigate the causes of stridor with respiratory distress and their clinical courses in children. METHODS: Children who were hospitalized in Samsung Medical Center due to stridor with respiratory distress without infectious causes were studied retrospectively. The causes of stridor, sex, age at onset, symptoms, combined diseases, treatment, and clinical courses were investigated. Fisher's exact test was used to assessing the association of risk factors with the severity of post-intubation subglottic stenosis. RESULTS: Of 75 cases, 15 (20 percent) were congenital and 60 (80 percent) were acquired. The prevalence in males was higher than in females. Common causes of congenital stridor were laryngomalacia, tracheomalacia, pulmonary artery sling and complete tracheal ring. Acquired stridor is usually due to subglottic stenosis secondary to endotracheal intubation. Risk factors such as frequency and duration of intubation, age at first intubation, birth weight and gestational age were not associated with the developement of post-intubation subglottic stenosis. (P> 0.05) More complicated surgical treatment was required according to the severity of subglottic stenosis. CONCLUSION: Congenital malformation of the airway requiring urgent surgical correction should be differentiated in children with stridor and respiratory distress. Post-intubation subglottic stenosis accounts for most cases of acquired stridor. Evaluation of it's severity, and careful airway care, is required in children with subglottic stenosis.

Keyword

Airway obstruction; Stridor; Endotracheal intubation

MeSH Terms

Airway Obstruction
Birth Weight
Child*
Constriction, Pathologic
Female
Gestational Age
Humans
Infant*
Intubation
Intubation, Intratracheal
Laryngomalacia
Male
Prevalence
Pulmonary Artery
Respiratory Sounds*
Retrospective Studies
Risk Factors
Tracheomalacia