Obstruction of the respiratory tract

Obstruction of the respiratory tract is divided into obstruction of the upper and lower respiratory tract.

When massive aspiration of any substrate develops asphyxia syndrome, in which the main damaging factor is the mechanical obstruction of the trachea, bronchi and bronchioles.

Such conditions, depending on the nature and amount of aspirated, may present an immediate threat to the life of the patient (partial or complete obstruction of the airway) or contribute to the development of pulmonary infection in the distant period (stasis of bronchial secretion, atelectasis).

Chemical damage usually develops only at low pH values of the aspirated liquid or the presence of other aggressive factors in it.

Large foreign bodies can clog the larynx or trachea, causing the development of aphonia, cyanosis, acute respiratory failure, loss of consciousness and sudden death.

With partial obstruction of the trachea, there is a two-phase stridorous respiration with expiratory whistling wheezing. When the foreign body is moving distally, the inspiratory stridor becomes less pronounced.

When a foreign body is in the main bronchus, one-sided wheezing sounds are heard (due to the turbulence of air currents and reflex bronchospasm).

With obstruction of the lobar or segmental bronchus, the asymmetry of respiration and local wheezing are auscultated. By easing breathing, we can indirectly judge the localization of the aspiration region and the development of atelectasis.

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What causes airway obstruction?

The causes of airway obstruction are various diseases and injuries. In cases where the obstruction of the gas flow during breathing occurs in the mouth, throat or larynx, respiratory disorders are considered due to obstruction of the upper respiratory tract, below the larynx - obstruction of the lower respiratory tract. Obstruction causes a total disruption of gas exchange - asphyxia, leading in some cases to death.

Causes of obstruction of the upper respiratory tract

Congenital diseases

Acquired diseases and injuries

Narrowing of the internal lumen of the respiratory tract: Subglottic stenosis; Membrane; Cyst; Laryngocele; Tumor; Laryngomalacia; Laryngotracheal-esophageal membrane; Tracheomalacia; Graocaesophageal fistula. External compression and damage: The vascular ring; Cystogyrogram. Birth injury. Neurological disorders. Anomalies of the craniofacial region. Hypocalcemia

Infections: Pharyngeal abscess; Angina Ludwig; Laryngotraheobronchitis; Epiglottitis; Fungal infection; Peritonsillar abscess; Diphtheria; Bacterial tracheitis. Injury: Lobic intestinal edema; Post tracheostomy stenosis. Burns of the respiratory tract (thermal or chemical). Aspiration of foreign bodies. Systemic disorders. Tumors. Neurological damage. Chronic obstruction of the upper respiratory tract. Hypertrophic tonsillitis and adenoids

In acute respiratory diseases, the leading role is played by the violation of external respiration with the subsequent development of respiratory hypoxemia.

General principles of treatment of acute airway obstruction in children, depending on the specific pathological condition: restoring upper air passages, eliminating bronchial obstruction, correction of metabolic disorders, antibiotic therapy, if necessary, intubation of the trachea and ventilation.