Clinical analysis of ni ne children with acute laryngitis complicated with negative pressure pulmonary edema and changes of inflammatory factors / 中国小儿急救医学

ABSTRACT

Objective To investigate ht e clinical characteristics and treatment of children with acute laryn gitis comlp icated with negative pressure pulmno ary edema(NPPE),and the changes of inflammatory factosr w ere monitored.Methods Data of 9 cases with acute laryngitis complicated with NPPE in pediatric intensive care unit from August 2010 to March 2015 we re analyzde .The levelso f TNF -αand IL-6 of 8 cases were detected at admission and checked agani forty-eihg t horu s after therapy.Ten children of acute laryngitis wi thotu NPPE were selected as disease cotn rol group, and ten healthy children as normal control group. Results (1)The onset of NPPE varied from 8 minutes to 2 hours following relief of obstruction,and presen-ted with acute respiratory disrt ess, decreased xo ygen saturation, tachycardai , rales on chest auscultation.All thees patients received therapeutic measures icn luding mechna ical ventilation,limiting the fluid input volume. The disappearance of rales on chest auscultation varied from 6 hours to 30 hours.Duration of mechanical ven-tilation was lse s than 48 hours,and all the children were cured.(2) Compared with the children of disease control group and normal control group,in acute phase the plasma levels fo TNF-αand IL-6 in children with NPPE were significantly higher ( P<0.01 ) .The indicators of NPPE group significantly decreased after 48 hours therapy( P<0.01 ) .Conclusion NPPE is manifested by rapid onset of respiratory distress after relief of the airway obstruction.The symptoms resolve rapidly if early support of breath and limiting the fluid input volume are applied properly.The inflammatory response is one of the possible mechanisms of NPPE.