Rigid bronchoscopies in pediatric patients with tracheobronchial foreign bodies: Our outcomes (original) (raw)
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Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration
Pakistan Journal of Medical Sciences, 2019
Objectives: Delayed diagnosis and treatment of tracheobronchial foreign body aspiration (FBA) in children may lead to morbidity and mortality. Our objective was to evaluate the anesthetic management, peri- and post-operative complications, and predisposing factors for postoperative intensive care unit (ICU) admission in children undergoing rigid bronchoscopy due to tracheobronchial FBA. Methods: This retrospective study included 81 children who underwent rigid bronchoscopy between January 2010 to July 2018 at Inonu University, Department of Pediatric Surgery, Turkey. Data regarding demographic characteristics, anesthetic management, length of ICU and hospital stays, and peri- and post-operative complications were retrieved from the hospital database. Results: The patients included 54 (66.7%) boys and 27 (33.3%) girls with a mean age of 29.6±31.2 months. The most common presenting symptom was the suspicion of FBA, followed by acute-onset cough, cyanosis, wheezing and respiratory dist...
Anesthetic Management of Tracheobronchial Foreign Body Aspiration Cases in Children
Academia Anesthesiologica International, 2019
Background: Foreign body aspiration is one of the most common emergencies in paediatrics and is a leading cause of mortality and morbidity in otherwise normal and healthy children. Present study analyses the anaesthetic management and outcome of tracheobronchial foreign body cases in paediatric age group in a span of one year in a tertiary care paediatric hospital setting. Subjects and Methods: Present retrospective study was conducted in patients subjected to diagnostic and therapeutic bronchoscopy for suspected foreign body removal from March 2017 to April 2018. The subjected data was collected as per age, sex, suspected history of foreign body aspiration, clinical features and their duration, location and type of foreign body based on physical examination and radiological evaluation, anaesthetic management and outcome, Intraoperative and postoperative complications if any, postoperative mechanical ventilation if required. All children underwent bronchoscopy using Storz rigid bronchoscope. Results: Seventy two cases underwent bronchoscopy, in 08 cases esophagoscopy was done, 30 patients underwent laryngoscopy out of which one patient required esophagoscopy as well. In 84.1% cases we were able to retrieve foreign bodies, while 15.9% had negative bronchoscopy. 32% patients had vegetative foreign bodies and most common in these were peanuts. Coin was the most common non-vegetative foreign body retrieved during laryngoscopy. On bronchoscopy it was discovered that the most common site of lodgement of foreign bodies was in right main bronchus followed by left main bronchus. Conclusion: Tracheobronchial foreign bodies are frequently observed in young children with serious life threatening effects. There is need for preventive measures including parental education and awareness.
Iranian Journal of Otorhinolaryngology, 2017
Introduction Tracheobronchial foreign body aspiration is a common life-threatening condition in children. There are controversies in the management of this condition, including the type of ventilation during bronchoscopy. This study aims to compare anesthesia with controlled ventilation versus spontaneous ventilation in rigid bronchoscopy in children with foreign body aspiration. Materials and Methods: Patients who were candidates for rigid bronchoscopy due to foreign body aspiration were randomly assigned to either anesthesia with spontaneous ventilation or controlled ventilation. End tidal CO2 (ETCO2), electrocardiogram (ECG), heart rate (HR), oxygen saturation (SpO2), non-invasive blood pressure (NIBP) and complications and accidents during the surgery and recovery were recorded for each patient. Surgeon comfort during the procedure was also evaluated for each patient. A 20% change in HR or NIBP was considered significant. SpO2 values under 90% are considered desaturation. Result...
International Journal of Pediatrics, 2017
Background Although both methods of spontaneous respiration and controlled ventilation during anesthesia are safe and effective for managing children with foreign body aspiration, there is no consensus from the literature as to which technique is optimal. This study aimed to determine the outcomes of anesthetic techniques in pediatric rigid bronchoscopy for foreign body removal. Materials and Methods In this retrospective cross sectional study, all children underwent rigid bronchoscopy for managing foreign body aspiration at Mofid hospital, Tehran, Iran from 2009 to 2015 were enrolled. Data gathering was done by a surgical technologist and using a structured checklist. The measured variables included gender, age, weight, and duration of anesthesia, duration of bronchoscopy, hospitalization in intensive care unit (ICU), and recovery time, and possible major and minor complications. Results Totally, 159 patients were assessed of whom 10 (6.5%) were maintained spontaneous respiration a...
Purpose: In foreign body aspirations, the basic instrument is rigid bronchoscope which provides simultaneous ventilation. However, it can be difficult to tolerate the procedure due to air leaks which affects the effeciency of the procedure.Methods: In 2021, 10 pediatric patients, who were performed rigid bronchoscopy with the suspicion of foreign body aspiration in our clinic were included. Patients' age, gender, anamnesis, imaging findings, interventional procedure, intensive care and service length of stay, and mortality data were recorded. In the procedures performed under general anesthesia, a system combining intubation tube and rigid bronchoscope was used named as “rigid bronchoscopy with cuff”.Results:Rigid bronchoscopy was performed on 10 patients (6 male/ 4 female). The median age was 30 months (min: 9 months, max: 11 years). All foreign bodies were organic and were completely removed during the procedure. While no mortality was observed during the procedure, one patien...
Foreign body aspiration in children and role of flexible bronchoscopy: A 3year experience
The Gazette of the Egyptian Paediatric Association, 2016
Background: Flexible airway bronchoscopy is an accepted and frequently performed procedure in the evaluation of children with known or suspected airway and lung parenchymal disorders. Methods: Between 2012 and 2015, retrospective analysis of 134 flexible bronchoscopies was done in Children's Hospital, Cairo University, as regards demographic profile, clinical and radiological presentation and diagnostic indication. The results were analyzed on the basis of bronchoscopy inspection, conclusion and future recommendations. Results: Patients indicated for flexible bronchoscopy presented clinically with unilateral diminished breath sounds in 24.6%, unilateral bronchial breathing in 17.9%, recurrent lower respiratory tract infection in 11.2%, persistent cough in 4.5% and stridor in 9.7%, others showed radiological findings in the form of unilateral hyperinflation in 9%, bronchiectasis in 3.7% and unilateral wheezes in 1.5%. Out of 134 patients undergoing bronchoscopy, 38% had foreign body (FB) in the airways although only 7.5% of patients had recalled a previous history of FB aspiration (15.6% in the trachea, 52% in the right side and 31.3% in the left side, among those patients 60.8% were males while 39.2% were females), 14.1% had tracheal abnormality, 26.8% had post inflammatory changes, 56.7% had right bronchus abnormality, 55.2% had left bronchus abnormality, bronchoalveolar lavage (BAL) was done in 30.6% of patients, FB was successfully removed in 15.6% of patients and further cardiothoracic intervention was needed in 29.8% of patients. Conclusion: The combination of history, physical examination, and chest X-ray findings are crucial when investigating a child with suspected foreign body aspiration. Flexible bronchoscopy is effective for diagnostic and sometimes therapeutic purpose of problems in the upper and lower respiratory airways in children, with a high success rate as it significantly reduces the rate of negative rigid bronchoscopies and ultimately saves the child from undergoing an unnecessary procedure.
Revista do Hospital das Clínicas, 2002
Foreign body aspiration (FBA) is one of leading causes of death in children, especially among those younger than 3 years of age. The inhalation of a foreign body may cause a wide variety of symptoms, and early diagnosis is highly associated with the successful removal of the inhaled foreign material. Despite the great advances in endoscopic procedures and anesthesia, a large number of difficulties and complications still result from foreign body aspiration. We describe 5 cases of serious acute complications following aspiration of foreign bodies that became lodged in the tracheobronchial tree, including pneumomediastinum, pneumothorax, total atelectasis, foreign body dislodgment, and need for thoracotomy in children admitted into our intensive care unit in 1999 and 2000; these were all situations that could have been prevented with early recognition and prompt therapeutic intervention.
Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation
Pediatric Anesthesia, 2004
Foreign body aspiration is a leading cause of death in children 1-3 years old, although mortality is low for children who reach the hospital. Presenting symptoms of an inhaled foreign body depends on time since aspiration. Immediately after inhalation the child starts to cough, wheeze, or have laboured breathing. If the early signs are missed, the child usually presents with fever and other signs and symptoms of chest infection. A plain chest X-ray has relatively low sensitivity and specificity for inhaled foreign body. The gold standard for diagnosis and management of this condition is rigid open tube bronchoscopy under general anaesthesia. For late presentations, time should be taken to fast the child and complete a thorough evaluation before bronchoscopy. The procedure should be performed in a well-equipped room with at least two anaesthesiologists, one with paediatric experience, in attendance. Most experienced anaesthesiologists prefer inhalational rather than intravenous induction of anaesthesia and a ventilating bronchoscope rather than intubation. Equally good results have been reported with spontaneous ventilation or positive pressure ventilation; jet ventilation is not advocated for foreign body removal in children.
The Efficacy of Rigid Bronchoscopy for Foreign Body Aspiration
Bulletin of emergency and trauma, 2014
The aim of the current study was to determine the pattern, presentation and management of foreign body aspiration in our population. This prospective study comprised 55 patients with foreign body aspiration admitted to our department from January 2009 to December 2011. All patients underwent rigid bronchoscopy under local or general anesthesia. The patients' demographic information along with clinical characteristics and their outcome were recorded and reported. The mean age of the children was 13.3±3.6 years. There were 32 (58.2%) females and 23 (41.8%) males. The frequent symptom was an attack of chocking followed by cough. The predominant sign was wheezing. Rigid bronchoscopy was successful in removing foreign body from 52(94.5%) patients. Three (5.5%) patients who had undergone thoracotomy with bronchotomy needed exploration, after failure of bronchoscopy to remove the foreign body. There was no mortality in our series. Average hospital stay was 12 hours. It could be concl...