Acute Respiratory Failure (ARF) Due to Airway Obstruction: Laryngospasm


  1. Introduction
  2. Etiology of Laryngospasm
  3. Pathogenesis of Laryngospasm
  4. Emergency Management of Laryngospasm
  5. Summary


Acute respiratory failure (ARF) due to airway obstruction can occur in several conditions including laryngospasm, bronchospasm, various asthmatic conditions, foreign bodies in the upper airways, drowning, pulmonary embolism (PE), spontaneous pneumothorax, lung atelectasis, massive exudative pleuritis, massive pneumonia, strangulation asphyxia, aspiration pneumonitis, and other pathological states.

Etiology of Laryngospasm

Laryngospasm is caused by either mechanical or chemical irritation of the airways. The etiological factors include:

  • Foreign bodies
  • Inhaled irritants
  • Allergens
  • Gastroesophageal reflux
  • Infections
  • Post-surgical complications
  • Trauma

Pathogenesis of Laryngospasm

The pathogenesis of laryngospasm involves a reflexive spasm of the striated muscles that regulate the glottis. This spasm can cause partial or complete closure of the vocal cords, leading to a significant reduction in airflow into the lungs and causing acute respiratory distress.

Emergency Management of Laryngospasm

  1. Initial Assessment:
  • Quickly assess the patient’s airway, breathing, and circulation (ABCs).
  • Ensure that the patient is in a position that promotes optimal breathing, such as sitting up.
  1. Airway Management:
  • Clear any visible foreign bodies from the mouth and throat.
  • If the patient is conscious and able to cooperate, encourage coughing to expel any foreign material.
  1. Oxygen Therapy:
  • Administer high-flow oxygen using a mask to ensure maximum oxygenation.
  1. Medications:
  • Administer a rapid-acting muscle relaxant if the spasm persists and airway obstruction is critical.
  • Consider the use of bronchodilators if there is concurrent bronchospasm.
  1. Advanced Airway Management:
  • If basic interventions fail and the patient remains in severe respiratory distress, intubation or a tracheostomy may be necessary.
  • In some cases, anesthetic agents may be used to reduce muscle spasm and facilitate intubation.
  1. Monitor and Support:
  • Continuously monitor the patient’s vital signs, oxygen saturation, and clinical status.
  • Prepare for potential complications, such as hypoxia or cardiac arrest, and be ready to perform cardiopulmonary resuscitation (CPR) if necessary.


Laryngospasm is a serious condition that can lead to acute respiratory failure due to obstruction of the airway. Prompt recognition and immediate intervention are crucial to prevent hypoxia and other complications. Effective management involves clearing the airway, providing high-flow oxygen, administering appropriate medications, and potentially performing advanced airway maneuvers if necessary.