Abstract
Croup is the single most common cause of death from airway obstruction, taking all ages into account. The patient’s general appearance is an extremely unreliable guide to the severity of the obstruction in croup and specific signs must be used in the assessment. Management is discussed. It is emphasized that chest physiotherapy is specifically contra-indicated in conservatively managed children with croup. But in children who have had artificial airways inserted for life-threatening airway obstruction regular intensive chest physiotherapy is essential.
Highlights
OPSOMMING Kroep is die enkele mees gewone oorsaak van dood deur lugwegobstruksie as alle ouderdomme in aanmerking geneem word
Artificial Airways Children with grade III or IV croup are admitted to an intensive care unit
An artificial airway is inserted as a matter of urgency when grade IV obstruction fails to show almost im mediate improvement to grade III or better on adrenaline
Summary
Croup describes the clinical syndrome produced by acute obstructive infraglottic laryngitis, whatever the cause. Airway obstruction in croup occurs from inflammatory swelling of the larynx immediately below the vocal cords, the name obstructive infra-glottitis. It is only the subglottic portion of the larynx which becomes sufficiently obstructed in croup to pose a threat to life The reason for this peculiarity is that submu cosal glands are profuse in the subglottis but relatively sparse in the trachea. It is the distension of these glands which is the major cause of the airway obstruction in croup. A discussion of other causes of laryngeal obstruction is beyond the scope of this paper: epiglottitis, anaphylaxis, la ryngeal papillomata and laryngeal foreign bodies They are generally fairly easy to distinguish from croup by history alone
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