From the Guidelines
The treatment of inhalation airway lesions, specifically infantile hemangiomas, should prioritize propranolol therapy as the standard of care due to its reported success and low complication rates. The management of airway IHs depends on several factors, including the degree of airway obstruction, the extent of extralaryngeal IH, and the location of the patient at the time of diagnosis 1. For symptomatic cases, propranolol has become a desirable alternative to traditional interventions such as endoscopic laser ablation or surgical excision, which were often recommended before the advent of propranolol therapy 1.
Some key considerations in the management of airway IHs include:
- The need for prompt assessment and management based on the severity and type of injury
- The importance of securing the airway and providing supplemental oxygen
- The use of propranolol as the standard of care, with dosing similar to that for cutaneous IHs
- The potential for tracheotomy in rare cases where observation is preferred or pediatric airway expertise is not readily available 1
- The role of "watchful waiting" in cases involving minimal symptomatology, given that involution is the ultimate fate of virtually all IHs 1
In terms of specific treatment protocols, the optimal dose and duration of propranolol therapy remain uncertain, but most clinicians are dosing the drug as they would for cutaneous IHs 1. Overall, the goal of treatment should be to prevent airway obstruction and ensure the best possible outcomes in terms of morbidity, mortality, and quality of life.
From the FDA Drug Label
The use of albuterol sulfate inhalation solution can be continued as medically indicated to control recurring bouts of bronchospasm To administer 2.5 mg of albuterol, administer the entire contents of one sterile unit-dose vial (3 mL of 0. 083% inhalation solution) by nebulization.
The treatment of inhalation airway lesion may involve the use of albuterol sulfate inhalation solution to control recurring bouts of bronchospasm. The recommended dosage is 2.5 mg administered three to four times daily by nebulization 2.
- Key points:
- Albuterol sulfate inhalation solution can be used to control recurring bouts of bronchospasm.
- The recommended dosage is 2.5 mg administered three to four times daily by nebulization.
- Budesonide inhalation suspension may also be used to treat asthma symptoms, but its use is not directly related to the treatment of inhalation airway lesion 3.
From the Research
Treatment of Inhalation Airway Lesion
The treatment of inhalation airway lesions involves several approaches, including:
- Airway management, such as the timing of intubation, method of intubation, and management of trachea-esophageal fistula formation and rupture 4
- Correction of carbon monoxide intoxication 4
- Use of medications such as heparin sulfate, N-acetylcysteine, and albuterol to help treat patients with inhalational burns 4
- Supportive respiratory care, including the use of bronchodilators, mucolytic agents, and inhaled anticoagulants 5
Medications Used in Treatment
Some medications that have been used in the treatment of inhalation airway lesions include:
- Albuterol, a short-acting beta2-agonist that can help relieve bronchoconstriction 6
- Budesonide, an inhaled corticosteroid that can help reduce airway inflammation 7, 8
- Heparin sulfate, which has been shown to help in the treatment of patients with inhalational burns 4
- N-acetylcysteine, which has been shown to help in the treatment of patients with inhalational burns 4
Alternative Treatments
Alternative treatments for inhalation airway lesions include: