{"id":6459,"date":"2024-09-29T14:01:57","date_gmt":"2024-09-29T14:01:57","guid":{"rendered":"https:\/\/paeder.com\/6459"},"modified":"2024-09-29T14:39:08","modified_gmt":"2024-09-29T14:39:08","slug":"6459","status":"publish","type":"post","link":"https:\/\/paeder.com\/en\/6459","title":{"rendered":"24-09 Stridor"},"content":{"rendered":"<div class='flex_column av-plj2tk-bd4084cef2fd7eeb625d629dc8fdea70 av_one_fifth  avia-builder-el-0  el_before_av_three_fifth  avia-builder-el-first  first flex_column_div '     ><\/div>\n<div class='flex_column av-ndax20-cbbbcca9a5fb8572e668a9b59981ac0e av_three_fifth  avia-builder-el-1  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-m1nngf54-39a72be10b8ee92a8846c2372d4147f7\">\n.avia-image-container.av-m1nngf54-39a72be10b8ee92a8846c2372d4147f7 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-m1nngf54-39a72be10b8ee92a8846c2372d4147f7 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-m1nngf54-39a72be10b8ee92a8846c2372d4147f7 av-styling- avia-align-center  avia-builder-el-2  el_before_av_hr  avia-builder-el-first '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-6447 avia-img-lazy-loading-not-6447 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761.jpg\" alt='' title='Header Stridor 1920 x 761'  height=\"761\" width=\"1920\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761.jpg 1920w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-300x119.jpg 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-1030x408.jpg 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-768x304.jpg 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-1536x609.jpg 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-1500x595.jpg 1500w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-705x279.jpg 705w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-450x178.jpg 450w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Header-Stridor-1920-x-761-600x238.jpg 600w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-mg8i48-3b0fe4cb83f39df74d5dceee694b6157\">\n#top .hr.hr-invisible.av-mg8i48-3b0fe4cb83f39df74d5dceee694b6157{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-mg8i48-3b0fe4cb83f39df74d5dceee694b6157 hr-invisible  avia-builder-el-3  el_after_av_image  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-l4wbt4-69b89a931bd057cea242880517525f97'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: right;\">September 25, 2024<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-j5bt6g-b561af23e18516f8b6e8f663f79d16e8\">\n#top .av-special-heading.av-j5bt6g-b561af23e18516f8b6e8f663f79d16e8{\npadding-bottom:10px;\ncolor:#fc0001;\n}\nbody .av-special-heading.av-j5bt6g-b561af23e18516f8b6e8f663f79d16e8 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-j5bt6g-b561af23e18516f8b6e8f663f79d16e8 .special-heading-inner-border{\nborder-color:#fc0001;\n}\n.av-special-heading.av-j5bt6g-b561af23e18516f8b6e8f663f79d16e8 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-j5bt6g-b561af23e18516f8b6e8f663f79d16e8 av-special-heading-h2 custom-color-heading  avia-builder-el-5  el_after_av_textblock  el_before_av_hr '><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >Help for infants and toddlers with stridor<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-h6akzs-a7964f2b1b39fd44a6ae8f02b0009cb6\">\n#top .hr.hr-invisible.av-h6akzs-a7964f2b1b39fd44a6ae8f02b0009cb6{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-h6akzs-a7964f2b1b39fd44a6ae8f02b0009cb6 hr-invisible  avia-builder-el-6  el_after_av_heading  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-fbc6aw-112772d3c6522db9bd2b7802e61de26d'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p class=\"EndNoteBibliography\"><span style=\"color: #333333;\"><strong><span lang=\"de\">Wherever children are encountered medically &#8211; in the doctor&#8217;s surgery, in the emergency services and in hospital &#8211; breathing sounds are one of the most important symptoms and can be of no or considerable significance.<\/span><\/strong><\/span><\/p>\n<h3><span style=\"color: #333333;\"><strong>1. fundamentals and acute events  <\/strong><\/span><\/h3>\n<p>  All newborns and infants have audible breathing with typical nasopharyngeal, i.e. close to a soft snoring sound, which often confuses parents and caregivers without experience with newborns.<br \/>\nAn experienced person should be asked to assess this at least once.   <span style=\"color: #fc0001;\"><span style=\"color: #c00d0d;\"><strong>NOTE:<\/strong><\/span><strong><span style=\"color: #c00d0d;\">  If you are thinking about a bronchoscopy, you should have it done!<br \/>\nA functional and anatomical examination (spontaneously breathing + at rest) is required for a complete diagnosis <\/span> <\/strong><\/span>  The following typical differential diagnoses result from the constellation of the type of stridor and medical history.<br \/>\nHowever, because there is <u>usually <\/u>a discrepancy between the symptoms and the nature, severity and significance of the underlying causes, a bronchoscopy with functional and anatomical examination of the airways should be performed <u>without hesitation<\/u>!<br \/>\nNo other examination method is suitable for making a diagnosis and thus possibly ruling out a significant threat.<br \/>\nThe term <strong>&#8220;true&#8221; stridor<\/strong> refers to an amplified respiratory sound that can be heard without aids and is caused by turbulent airflow at narrow points in the airways.<br \/>\nThe first step is to assess the quality of the sound and take a thorough medical history.<br \/>\nFar too often &#8211; and usually incorrectly &#8211; stridor in newborns and small infants is postulated to be tracheomalacia!<br \/>\nThe following typical differential diagnoses (and many very rare diagnoses that cannot all be listed here) result from the constellation of the type of stridor and the medical history. <strong>Sudden onset of breath sounds<\/strong> indicates an acute event, the most important diagnoses are as follows.<br \/>\nA sudden onset of respiratory distress with expiratory stridor and delay in expiration suggests <strong>asthma<\/strong> in particular.<br \/>\nThe smaller the child, the more valuable the examination is, in addition to auscultation, by placing the hands on the thorax: spasms, secretions, breathing patterns and congestion can be felt and localized.<br \/>\nThe therapeutic procedure with regard to inhalation therapy hardly differs from the adult (Table 1).<br \/>\nThe sudden onset of inspiratory stridor with a barking cough is usually <strong>croup syndrome<\/strong>, which occurs most frequently in the context of viral infections but also spontaneously and is caused by subglottic swelling of the mucous membrane.<br \/>\nThis disease rarely becomes threatening and can be treated in the same way as asthma.<br \/>\nHowever, differential diagnoses include tracheitis and epiglottitis (see below).<br \/>\nEspecially in the absence of vaccinations and a progression of hoarseness, inspiratory stridor and barking cough &#8211; which can typically be triggered by pressing a spatula on the tongue &#8211; <strong>diphtheria<\/strong>, which used to be called &#8220;true croup&#8221;, should also be considered. <span style=\"\"><strong>Table 1: Drug therapy for asthma attacks or pseudo-croup (from [1]).<\/strong><\/span><\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-evk6rs-d300c1fc15a6a9df901dda3d124bcce9\">\n#top .hr.hr-invisible.av-evk6rs-d300c1fc15a6a9df901dda3d124bcce9{\nheight:40px;\n}\n<\/style>\n<div  class='hr av-evk6rs-d300c1fc15a6a9df901dda3d124bcce9 hr-invisible  avia-builder-el-8  el_after_av_textblock  el_before_av_image '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-m1no023y-c9247bedddbaca7c42e40152228c9235\">\n.avia-image-container.av-m1no023y-c9247bedddbaca7c42e40152228c9235 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-m1no023y-c9247bedddbaca7c42e40152228c9235 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-m1no023y-c9247bedddbaca7c42e40152228c9235 av-styling- avia-align-center  avia-builder-el-9  el_after_av_hr  el_before_av_textblock '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-6509 avia-img-lazy-loading-not-6509 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1.png\" alt='' title='Tabelle Therapie bei Asthma oder PseudoKrupp'  height=\"2440\" width=\"4424\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1.png 4424w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-300x165.png 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-1030x568.png 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-768x424.png 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-1536x847.png 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-2048x1130.png 2048w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-1500x827.png 1500w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-705x389.png 705w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-450x248.png 450w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Tabelle-Therapie-bei-Asthma-oder-PseudoKrupp-1-600x331.png 600w\" sizes=\"(max-width: 4424px) 100vw, 4424px\" \/><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-m1norbcu-963a9ba20e2bd1ff35c4bf466efb3400'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>Epiglottitis<\/strong> has become more common again in recent years, partly due to a lack of vaccinations but also because of other pathogens.<br \/>\nIn contrast to croup syndrome, however, the children show signs of a severe bacterial infection with high fever and a considerably impaired general condition.<br \/>\nA preclinical intubation attempt is only indicated in extreme emergencies and can be very problematic in the case of a purulent swollen epiglottis.<br \/>\nThe target hospital must be informed of the suspected diagnosis as early as possible so that an experienced team is available on arrival.<br \/>\n <strong>Tracheitis<\/strong>, which is clinically indistinguishable from epiglottitis, is now the most common life-threatening respiratory infection.<br \/>\nIt can only be diagnosed by bronchoscopy.<br \/>\nThese children are generally easy to intubate, but fiberoptic intubation should still be performed to ensure thorough suctioning (caution: tube obstruction due to purulent secretions) and simultaneous sampling.        <\/p>\n<h3><strong>2. the inspiratory stridor<\/strong><\/h3>\n<p><strong>Inspiratory high-frequency stridor is usually a problem in or near the vocal cord level.  <\/strong>The most important differential diagnoses are laryngomalacia and vocal cord paresis.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-m1nos02f-129dab388ce983b21fdcd68734f51923\">\n.avia-image-container.av-m1nos02f-129dab388ce983b21fdcd68734f51923 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-m1nos02f-129dab388ce983b21fdcd68734f51923 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-m1nos02f-129dab388ce983b21fdcd68734f51923 av-styling- avia-align-center  avia-builder-el-11  el_after_av_textblock  el_before_av_hr '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-6515 avia-img-lazy-loading-not-6515 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2.png\" alt='' title='Inspiratorischer hochfrequenter Stridor Differentialdiagnose'  height=\"1436\" width=\"4406\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2.png 4406w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-300x98.png 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-1030x336.png 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-768x250.png 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-1536x501.png 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-2048x667.png 2048w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-1500x489.png 1500w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-705x230.png 705w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-450x147.png 450w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/09\/Inspiratorischer-hochfrequenter-Stridor-Differentialdiagnose-2-600x196.png 600w\" sizes=\"(max-width: 4406px) 100vw, 4406px\" \/><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1456l4-e3c48b1f93e25871baf8212de1e30889\">\n#top .hr.hr-invisible.av-1456l4-e3c48b1f93e25871baf8212de1e30889{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-1456l4-e3c48b1f93e25871baf8212de1e30889 hr-invisible  avia-builder-el-12  el_after_av_image  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-wcek8-98f2d25cb40288d6866354ea45985c78'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p class=\"EndNoteBibliography\"><strong>Literature:<\/strong><\/p>\n<ol>\n<li class=\"EndNoteBibliography\"><span style=\"font-family: arial, helvetica, sans-serif;\">Laschat  <span lang=\"de\" style=\"font-size: 11pt; line-height: 115%;\">M, Kaufmann J, Wappler F. Laryngomalacia with Epiglottic Prolapse Obscuring the Laryngeal Inlet.<br \/>\nAnesthesiology 2016; 125: 398, DOI: 10.1097\/ALN.0000000000001035 <\/span><\/span><\/li>\n<\/ol>\n<\/div><\/section><br \/>\n<div  class='av-social-sharing-box av-tdg94-07f1e0c322037bc7b32ff94182816531 av-social-sharing-box-default  avia-builder-el-14  el_after_av_textblock  el_before_av_hr  av-social-sharing-box-fullwidth'><div class=\"av-share-box\"><h5 class='av-share-link-description av-no-toc '>Share post<\/h5><ul class=\"av-share-box-list noLightbox\"><li class='av-share-link av-social-link-facebook' ><a target=\"_blank\" aria-label=\"Share on Facebook\" href='https:\/\/www.facebook.com\/sharer.php?u=https:\/\/paeder.com\/en\/6459&#038;t=24-09%20Stridor' aria-hidden='false' data-av_icon='\ue8f3' data-av_iconfont='entypo-fontello' title='' data-avia-related-tooltip='Share on Facebook' rel=\"noopener\"><span class='avia_hidden_link_text'>Share on Facebook<\/span><\/a><\/li><li class='av-share-link 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