Jul 10, 2011 - Child. Health,. Section of. Respimlog. University of Manitoba,. Winnipeg, ... 102:963-65) cute upper airway obstruction commonly presents with.
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
Downloaded from chestjournal.chestpubs.org at COMMAX GROUP on July 10, 2011 © 1992 American College of Chest Physicians
ACKNOWLEDGMENT: ological assistance
Dr. Susan advice, and
and
Miner Cathy
provided Harrell
Table
excellent pathgave secretarial
1-Changes
in Median
assistance.
Inspiration REFERENCES
1Almassi
Chapman
GH,
GN.
Constrictive
the
PD,
pencarditis
automatic
0.2
Troup
PG.
Wetherbee
associated
implantable
with
JN,
patch
electrodes
cardioverter-defibrillator.
2 Singer
I, Hutchins
Cuarnieri
GM,
Mirowski
P Pathologic
repeated
findings
defibrillations
in patients
cardioverter-defibnllator.
Taylor
RL,
Cohen
Infection
DJ,
of an
ment
without
1990;
13:1352-63
4 Furman
1987;
Widman
LE,
implantable
1987;
AJ,
the
permanent
cardiac
removal.
Ann
Surg
5 Wunderly
Thorac
D,
Infections
in
PACE
7 Goodman
J,
1990;
Lii,
Chapman
verter
managecases.
c
n/a
d
9
Bryant
LR,
Trinkle
management M,
JK.
Implantable
PM.
within
PJ, Gurney
atopy,
or
defibrillator
radiographic,
C’L
implantable and
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
Department
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
the
patient
sat
and
Sound
and
air
the
of Spirometry* a
1.78
b
1.75
90
supraster-
c
1.95
88
d
1.95
78
86
3.08
2.28
2.82
3.36
2.28
0.86
1.85
0.52
0.85
1.40 0.72
second;
>1
forced PEF,
F1F50,
forced
forced
expiratory
vital
capacity;
peak
FEy,,
expiratory
inspiratory
flow
flow
at 50%
CHEST
forced flow;
at 50% of vital
/102
expiratory
PIF,
peak
of vital
volume
inspiratory
capacity
1.79 85
Vs
*F’VC,
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
tp