The airway obstruction - important abrupt condition for pediatrics

Abstract

The ability of fast response in case of increasing health problems of a child which lead directly to life-threatening situations is a necessary condition for creating opportunity of child’s survival until it will be transported to intensive care unit, where it will be provided with care by a specialist. In case of healthy children the most common cause of acute respiratory fa ilure is obstruction of upper respiratory tract. There is an enormous variety of causes of upper airway obstruction, but the most important are the result of congenital defects, acute inflammation, anaphylactic reactions, foreign body aspiration and injuries. Consequence of the hypoventilation resulting from significant impediment of airflow through the obstructed airways is impa ired gas exchange in the lungs. This leads to the increasing hypoxemia (PaO 2 <60 mmHg) and hypercapnia (PaCO2> 45 mmHg). This condition is called the total respiratory failure. The persistence of hypoventilation leads to hypoxia of vital organs (heart muscle, brain), increased anaerobic metabolism, acidosis, and inevitably to cardiac arrest as a result of homeostasis disorders. Respiratory failure is defined as acute when developing suddenly and is potentially reversible. We can find such a situation in the fast-increasing stenosis of the larynx. Symptoms of severe dyspnoea occur in a short time, but can be interrupted by an effective airway patency. Acute respiratory failure is a state of direct threat to life, which is why it is crucial to give a prompt aid to the sick child. The aim of this paper is to discuss the signs and symptoms, knowledge of which is essential for rapid identification and initial differentiation of the causes of acute upper airway obstruction in children. The principles of first-aid for children with acute respiratory failure and above all the description of life-saving procedures will be presented.