Tracheal sounds in upper airway obstruction

Tracheal sounds in upper airway obstruction. H Pasterkamp and I Sanchez Chest 1992;102;963-965 DOI 10.1378/chest.102.3.963 The online version of this article, along with updated information and services can be found online on the World Wide Web at: http://chestjournal.chestpubs.org/content/102/3/963

Chest is the official journal of the American College of Chest Physicians. It has been published monthly since 1935. Copyright1992by the American College of Chest Physicians, 3300 Dundee Road, Northbrook, IL 60062. All rights reserved. No part of this article or PDF may be reproduced or distributed without the prior written permission of the copyright holder. (http://chestjournal.chestpubs.org/site/misc/reprints.xhtml) ISSN:0012-3692

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ACKNOWLEDGMENT: ological assistance

Dr. Susan advice, and

and

Miner Cathy

provided Harrell

Table

excellent pathgave secretarial

1-Changes

in Median

assistance.

Inspiration REFERENCES

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A boy

with

subglottic

cheitis

presented

ments

of tracheal

lated

and

M.D.;

echocardiographic

with Four

well

the

This

tory sound obstruction.

to laryngotra-

secondary

noisy

sounds

with

assessments.

narrowing with

M.D.t

Sanchez,

breathing.

Acoustic

at standardized

air

clinical

course

indicates

the

characterization

and

with

potential

in patients

cell

(Chest

102:963-65)

1992;

well

may musical

clinical also

lead

quality

sounds

tracheal

obstruction

respiratory

recognized

airways

the

airway

commonly

sounds. sign,

but

to greater

We

stridor

stenosis

of the

respiratory

of stridor.

report

in a boy with noisy and subglottic

with is a

presents

Inspiratory noise

upper

that

lacks

measurements

breathing

because

flows zation

laryngotracheitis

during the of tracheal

Fluoroscopy

upper

airway

method

to assess

inspiratory

flows.

negative,

but aurrus.

bacterial

day

for

and

on discharge

three

This

8#{189}-year-old the

effects

boy

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unchanged. distress

afebrile,

and

showed

some

copy

revealed

2 cm

below

the

worsening the

with

oral

was

begun,

there

had

and

spirometry

nal notch

in

for

REPORT was

previously

of Pediatrics

and

well Child

had acute Health,

Respimlog University of Manitoba, Winnipeg, Canada. tFellow, Manitoba Lung Association Reprint requests: Dr. Pasterkamp, AE 103, 671 William Winni peg, Manitoba, Canada R3E 0Z2

and

nonhemolytic

was

one

a nose

a calibrated

normal.

Spirometry

obstruction.

Bronchos-

subglottic

edema

secretions

streptococci. mg

home.

qid

for two

months

boy was

in place,

kept

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patient

sat

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of Spirometry* a

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forced

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capacity;

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flow

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forced flow;

at 50% of vital

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peak

of vital

volume

inspiratory

capacity

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Vs

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later, healthy,

at the

L/s

FIF,IFEF,,,

weeks,

site was

pneumotachograph.

Predicted

%

sounds

PEF,

of

grew

Treatment

Three The

still

extending which

PIF, of

and

was

recording

clip

2-Results

L

onset

week

of stndor He was

tracheal

sensor. The

With

Table

FEy,

was

fluoroscopy

admitted

of symptoms.

we recorded

a contact

Variable

but

interim.

500

was sent

better,

normal.

occasions, with

much

in the

purulent

of cloxacillin,

y-

2 mg/kg/ symptom

episodes

flow

cords,

auraus

through

Section

Avenue,

of inspiratory

no recurrence

already

remaining

count

thick,

all tests.

breathed

cell

patient

was

again

observed

and

the

prednisone,

Two

cords,

and been

was

for Staph

positive

with

improved,

patient

of the vocal

administration

of

same

he only

blood

swelling

with were

the

hoarseness.

subglottic

secretions

day,

white

the

of tracheal returned

clearly

normal

lymphopenia

obstruction

later,

been

breathing retractions The white

high

with of

next

had

in moderate

Noisy

airway

the

The

and

narrowing

days

of persisting

remained Childrens

relative

treated

was

but

and

was

On three

because

later

the

to the

afebrile

(14.6x10/L)

studies

to

temporarily

erythematous.

extrathoracic

patient

days.

FEV,/FVC,

who

five

There

admitted

muscles, and chest clear on auscultation.

cultures

The

was

responded

he was

Viral

Spirometry

On four

obstruction. CASE

aFrom

therapeutic

N,

than

or fever.

transferred

showed

reduced lococcus

boy

no left shift,

indicated

course of the illness. Objective characterisounds may provide a noninvasive and

effort-independent

Hz;

(less

epinephrine

was

normal

Spirometry

of

stenosis, We found the sound spectral characteristics at given an-flows to correlate well with changes in maximum inspiratory and expiratory acute

to 2,400

cough

He

he was

throat

was

Staphylococcus

cute upper abnormal

racemic

later,

(65 percent),

percent).

the

inhaled

The

count

respiratory

airway

later,

of stridor.

trachea.

later

of respira-

upper

days

because

use of accessory The lungs were

count

remained

corre-

spirometric

value

with

50

available

without

On admission,

distress.

hoarseness.

measureflows

distress

days

Winnipeg.

blood

in Upper Airway Igtsacio

Two

without stridor, were noticed.

cardio-

(22

Pasterkamp,

from

not

t-test).

respiratory

treatment

neutrophil

Hans

136±8f

gate).

hospital

respiratory

1989; 170:447-52

Tracheal Sounds Obstruction*

band

n/a,

student’s

croup.

symptomatic.

JW, Veseth-Rogers

of automatic

flow

and

Hospital Troup

in the spectra;

(unpaired

community

patients.

cardioverter

574±79t

7

±SEM

frequency averaged

hoarseness

323±25

8

was no history of trauma or choking, and other family members were not ill at the time. The past history was negative for asthma,

without

McCarthy

of

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