S: From 1985 to May 2000, we have experienced 125 cases of stenting for central

S: From 1985 to May 2000, we have experienced 125 cases of stenting for central airway stenosis (malignant: 98 cases, benign: 27 cases). Nd-YAG laser vaporization, balloon dilatation, argon plasma coagulator and/or core out were Anle138b site performed to dilate the bronchial lumen before stentings. T-tube, Dumon stent, self-expandable metallic stent (SEMS) and Dynamic Stent were used. All stentings were performed under a fluoroscope. A rigid bronchoscope was used for all cases of Dumon stent and some cases of SEMS. Result: The number of combination stentings was 20 cases (male: 14, female: 6) out of 125 cases (16.0 ). A total of 45 stents were placed in 20 cases. Mean age was 58.5 years old. Nineteen out of 20 cases were malignant stenosis (lung cancer: 10, esophageal cancer: 6, Mets: 3). Four cases of tracheal-esophageal fistula were observed. One case of benign stenosis was bronchial malacia. The cases of synchronous insertions were 13, metachronous 5, synchronous and metachronous 2. SEMS were frequently selected in 17 out of 20 cases (85.0 ) because of its easy procedure (SEMS + SEMS: 8, SEMS + Dumon: 6, SEMS + Dynamic Stent: 2, SEMS + Eso.Stent: 1, Dumon + Dumon: 2, Dynamic + Eso.Stent: 1). Rigid bronchoscope was used for stent insertion in 80.0 (36 out of 45 stents) because of severe and complicated stenosis. NdYAG laser was used in 37.8 (17/45 stents). After stenting, chemotherapy and/or radiation could be done in 4 out of 10 cases of lung cancer, in 3 out of 6 cases of esophageal cancer. Improvement of QOL and lung function were obtained after stentings (PS: 3.3?.0, Hugh-Jones: 4.1?.7, PO2: 79.7?4.7 Torr in room air, VC: 77.6?4.7 , FEV1.0 :61.0?3.6 , PF: 2.13?.73 l/s).SCritical CareVol 5 Suppl21st International Symposium on Intensive Care and Emergency MedicineConclusions: Reconstruction of tracheobronchial stenosis by combination stenting was a very useful modality for end stage lung patients with severe central airway stenosis for the purpose ofPimproving pulmonary functions and quality of life. Selection of stents should be done after careful consideration of the characteristics of stents and tracheobronchial stenosis.Ulcerative laryngitis in children admitted to intensive careM Hatherill, Z Waggie, L Reynolds, A Argent PICU, Red Cross War Memorial Children’s Hospital, Cape Town, 7701, South Africa Background: Severe ulcerative laryngitis is rarely documented in children. Objective: To present our experience of ulcerative laryngitis over a 5 year period. Setting: Paediatric Intensive Care Unit (PICU) of a university hospital. Methods: Retrospective case note review of 263 children admitted to PICU with severe upper airway obstruction and a clinical diagnosis of croup. Data are presented as median (range) and analysed by the Fisher’s Exact test. Results: One hundred and forty-eight children (56 ) underwent microlaryngoscopy (Storz 3.0 rigid telescope), usually at the time of airway intervention for failed medical treatment of severe croup (n = 147). Laryngeal ulceration, with or without exudation, oedema and erythema, was documented in 15 of these children (10 ), median age 14 months (10?6) and median weight 10 kg (6?2). Twenty-seven of the children who underwent microlaryngoscopy PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20718733 (18 ) also had ulcerative gingivostomatitis consistent with Herpes simplex virus. Ulcerative laryngitis was documented in 9 of 27 (33 ) children with, and in 6 of 121 (5 ) children without, co-existent ulcerative gingivostomatitis (P < 0.002). The presence of o.