scholarly journals Clinical analysis of tracheobronchial foreign body aspiration in children: a focus on external and intrinsic factors

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weigang Gan ◽  
Ning Xiao ◽  
Yiyuan Feng ◽  
Danmei Zhou ◽  
Juanjuan Hu ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pediatric Patients ◽  
Treatment Delay ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
External Factors ◽  
Factors Affecting ◽  
Intrinsic Factors ◽  
Common Location ◽  
Tracheobronchial Foreign Body

Abstract Background Tracheobronchial foreign body aspiration (TFBA) is a critical disease in children and is extremely dangerous, even life-threatening. The factors affecting the occurrence and prognosis of TFBA are complex. The purpose of this study is to examine the external and intrinsic factors affecting clinical features of TFBA in West China and propose potential effective intervention measures. Methods We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA with foreign bodies (FBs) removed by rigid bronchoscopy under general anesthesia at the otolaryngology department from December 2017 to November 2018. The data included age, sex, clinical symptoms, type and location of FB, guardians, prehospital duration and residence of these pediatric patients. Results The ratio of males (72) to females (53) was 1.4:1. Children aged from 1 to 3 years accounted for 76% (95/125) of patients. Cough, continuous fever and dyspnea were the primary symptoms. The right primary bronchus was the most common location of FB detection by rigid bronchoscopy (67 cases, 53.6%). Organic FBs were most common in our study. Guardians of patients significantly differed in the rural (parents 16, grandparents 31) and urban (parents 52, grandparents 26) groups (χ2 = 12.583, p = 0.000). More children in the rural group than in the urban group had a treatment delay longer than 72 h. More children in the group with no history of FB aspiration (12, 25%) than in the group with prior FB aspiration had a treatment delay longer than 72 h. Conclusion Pediatric TFBA is a common emergency in otolaryngology. Age, sex, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FB species and prehospital time were defined as external factors of TFBA. External and intrinsic factors both influence the occurrence and progression of TFBA. It is extremely important to take effective measures to control external factors, which can decrease morbidity and mortality.

scholarly journals Clinical  analysis of tracheobronchial foreign body aspiration in children: A focus on external and intrinsic factors

2020 ◽  
Author(s):  
weigang gan ◽  
Ning Xiao ◽  
Yiyuan Feng ◽  
danmei zhou ◽  
juanjuan hu ◽  
...  
Keyword(s):  
Foreign Body ◽  
Clinical Analysis ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
External Factors ◽  
Clinical Feature ◽  
Factors Affecting ◽  
Intrinsic Factors ◽  
Tracheobronchial Foreign Body ◽  
Prehospital Time

Abstract BackgroundTo judge the external factors and intrinsic factors affecting clinical feature of TFBA in west China and propose potential effective intervention measures.Methods: We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA and removed foreign body(FBs) by rigid bronchoscopy under general anesthesia at otolaryngeal department from December 2017 to November 2018.ResultsThe gender constituent ratio of male(72) to female(53) was 1.4:1. The patients aged from 1 to 3 years accounting for 76% (95/125). Cough, continous fever and dyspnea were premier symptoms. Right primary bronchus was the most common position invovled where FBs were detected by rigid bronchoscopy in 67 cases(53.6%). Organic foreign bodis were commonest in our study. The guardians of patients between rural(parents 16, grandparents 31) and urban(parents 52, grandparents 26) group were significantly different(χ2=12.583, p=0.000). More children were paid attention delayedly over 72 hours in rural group than urban. More children in group of no hsitory of foreign body aspiration(12, 25%) were treated over 72 hours than in the contrary group.ConclusionPediatric tracheobronchial foreign body aspiration is a kind of common emergency in otolaryngology. Age, gender, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FBs species and prehospital time were defined as external factors of TFBA. External factors would determine the morbidity, and intrinsic factors would determine patient's condition and mortality. It is very important to take effective measures to control external factors, which was expected to decrease morbidity and mortality.

scholarly journals A Case of Whistle as Foreign Body in Trachea

2021 ◽  
Vol 6 (1) ◽  
pp. 1281-1286
Author(s):  
Puspa Zuleika
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Pediatric Patients ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Foreign Object ◽  
Case Presentation ◽  
Foreign Body Extraction ◽  
Tracheobronchial Foreign Body ◽  
History Of

Background. Most of foreign body aspiration cases are found in children under the age of fifteen. Pediatric patients often presents with non-food foreign body aspiration, such as toys. The most common clinical manifestation are history of choking following foreign object insertion into the mouth (85%), paroxysmal cough (59%), wheezing (57%) and airway obstruction (5%). Case presentation. Main principle of airway foreign body extraction is to do it immediately in the most optimal condition with slightest possible trauma. Rigid bronchoscopy is a suitable choice for tracheal foreign body extraction. We reported a case of seven years old male with tracheal foreign body presented with history of whistle ingestion five hours prior to admission. This patient was discharged from hospital after third days of rigid bronchoscopy procedure. Conclusion. History of foreign body aspiration in children should be suspected as a tracheobronchial foreign body. Rigid bronchoscopy is preferred to extract foreign bodies present in the trachea. The prognosis for tracheobronchial foreign body aspiration is good if the foreign body is treated early and without complications.

scholarly journals Tracheobronchial foreign body aspiration: A 13-year retrospective analysis

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 69-74
Author(s):  
Danijela Dragicevic ◽  
Ljiljana Jovancevic ◽  
Rajko Jovic ◽  
Ljiljana Vlaski ◽  
Bojan Bozic
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Age Groups ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Radiological Findings ◽  
Tracheobronchial Foreign Body ◽  
The Moment ◽  
The Right

Introduction. Foreign body aspiration into the respiratory tract remains a diagnostic and therapeutic challenge in clinical practice, especially in young children, who are the most frequently affected age group. The aim of this study was to present the results of treating the patients with foreign body aspiration in all age groups. Material and Methods. The medical and radiological records of 64 patients with confirmed foreign body out of 146 patients with suspected foreign body aspiration were retrospectively analyzed during the period of 13 years (from 2001 to 2013). Results. A foreign body was found in 64 (44%) of the 146 patients of all age groups with suspected foreign body aspiration. The patients? age ranged between 11 months and 80 years. There were 84% children and 16% adults, and 63% of patients were male. Time between the moment of aspiration and admission to the Department ranged between 0.5 hours and 14 days, with majority of patients (70%) being admitted during the first 24 hour. History of respiratory drama was present in 92% of patients. Physical and radiological findings were positive in 66% and 47% of patients, rescpectively. Organic vegetable foreign bodies accounted for 75% of all cases, and they were most frequently found in the right main bronchus (63%). All foreign bodies were successfully extracted by rigid bronchoscopy, without serious complications and fatal outcomes. Conclusion. Bronchoscopy should be performed in any case of suspected foreign body aspiration, even if clinical and radiological findings are normal, in order to avoid serious and possible life-threatening complications. More should be done to raise awareness of this potentially preventable condition.

scholarly journals ROLE OF RIGID BRONCHOSCOPY IN MANAGEMENT OF TRACHEOBRONCHIAL FOREIGN BODY ASPIRATION

2020 ◽  
Vol 28 (4) ◽  
pp. 345-347
Author(s):  
Israr ud Din ◽  
Muhammad Hafeez ◽  
Muhammad Junaid ◽  
Arif Raza Khan ◽  
Imran Khan
Keyword(s):  
Foreign Body ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Foreign Body Bronchus ◽  
Number Of Patients ◽  
Tracheobronchial Foreign Body ◽  
History Of ◽  
Male Patients ◽  
One Year

Objective: To determine the role of Rigid Bronchoscopy in Management of Tracheobronchial Foreign Body Aspiration. Material and Methods: This study was conducted in otolaryngology department, Khyber teaching hospital, Peshawar of one year duration from January 2018 to December 2019. Total 90 Patients of age 4 months to 14 years on clinical suspicion of foreign body bronchus were included, while patients with history of bronchial asthma, pulmonary tuberculosis and radio opaque foreign body bronchus were excluded. Results: Total number of patients was 90 in which male patients were 60 (66.67 %) and female patients were 30 (33.33 %), patients with foreign body bronchus were 80 (88.89%). Male patients with foreign body bronchus was 53 (58.89%) and female 27 (30.00%). In age range from 4 months to 3 years, 35(39%) Patients underwent bronchoscopy in which foreign body bronchus retrieved in 30(37.5%) patients. Conclusion: Patients with history of repeated chest infection, relieved by medicines for some time should not be over look, as vegetative foreign body bronchus are radiolucent and patients usually present late in respiratory compromised state, the clinician must urge, for prompt treatment as rigid bronchoscopy.

scholarly journals Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Ataman Köse ◽  
Dilek Kostak ◽  
Erol Aramagan ◽  
Aslıhan Durak ◽  
Nur Sezin Seçkin ◽  
...  
Keyword(s):  
Foreign Body ◽  
Signs And Symptoms ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Dental Prosthesis ◽  
Tracheobronchial Foreign Body ◽  
Bronchial System ◽  
Foreign Materials ◽  
Dental Apparatus ◽  
The Right

It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

scholarly journals Impacted denture in the left bronchus: aspiration in an awake state

2020 ◽  
Vol 6 (10) ◽  
pp. 1910
Author(s):  
Abhijit Raj ◽  
Susan K. Sebastian ◽  
Vikas Vijayan
Keyword(s):  
Foreign Body ◽  
Lower Lobe ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Left Lower Lobe ◽  
Lobe Bronchus ◽  
Partial Denture ◽  
Awake State ◽  
Left Bronchus ◽  
Tracheobronchial Foreign Body

<p class="abstract">Tracheobronchial foreign body aspiration is rare in adults. In adults it usually happens in a state of impaired alertness. We report a case of aspiration of a partial denture in an alert patient who presented with minimal symptoms. She was successfully treated with removal of the impacted denture from the left lower lobe bronchus by rigid bronchoscopy.</p>

scholarly journals Our Anesthesia Experiences in the Tracheobronchial Foreign Body Aspirations of Pediatric Patients During Rigid Bronchoscopy

2021 ◽  
Author(s):  
Yiğit Şahin ◽  
Tülay Çardaközü ◽  
Hüseyin Fatih Sezer
Keyword(s):  
Foreign Body ◽  
General Anesthesia ◽  
Similar Rate ◽  
Rigid Bronchoscopy ◽  
Muscle Relaxants ◽  
Foreign Body Aspiration ◽  
Anesthesia Induction ◽  
Inhalation Anesthetics ◽  
Tracheobronchial Foreign Body ◽  
The Right

Objective: Bronchoscopy is the gold standard in the diagnosis and treatment of tracheobronchial foreign body aspiration (TBFBA) in children. Rigid bronchoscopy (RB) under general anesthesia is generally preferred in children. In this article, our anesthesia experiences during rigid bronchoscopy performed for tracheobronchial foreign body aspiration and removal of foreign bodies in children are shared. Methods: The medical records of all patients aged between 0-18 years who underwent RB under general anesthesia due to suspicion of TBFBA between January 1, 2014 and December 31, 2018 were retrospectively analyzed. Results: TBFBA was more common in boys and organic foreign body aspiration was significantly higher in patients between 13-36 months of age. Patients most frequently presented with cough and wheezing. Most of them were operated between 8 am and 4 pm. TFBs were localized in the right and left main bronchi at a similar rate. Anesthesia induction was usually achieved with iv. propofol, total intravenous anesthesia and sevoflurane inhalation was administered for maintenance of anesthesia. Except for proximally located TBFBs, intermediate-or short-acting muscle relaxants were applied to most of the cases depending on the duration of the procedure. Three patients were intubated postoperatively and transferred to intensive care unit. Respiratory distress responded to medical treatment in 25 patients. No cardiac arrest or death occurred during the procedure. Conclusion: RB and anesthesia procedure for TBYCA requires experience. There is no clear recommendation about premedication, the use of muscle relaxants should be evaluated according to the localization of TBYC. In anesthesia management, intravenous or inhalation anesthetics can be used.

Evaluation of computed tomography virtual bronchoscopy in paediatric tracheobronchial foreign body aspiration

2010 ◽  
Vol 124 (8) ◽  
pp. 875-879 ◽  
Author(s):  
K V Bhat ◽  
J S Hegde ◽  
U S Nagalotimath ◽  
G C Patil
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Likelihood Ratio ◽  
Chest Radiography ◽  
Foreign Bodies ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Virtual Bronchoscopy ◽  
Plain Chest ◽  
Tracheobronchial Foreign Body

AbstractObjective:Virtual bronchoscopy is a noninvasive technique which provides an intraluminal view of the tracheobronchial tree. This study aimed to evaluate this technique in comparison with rigid bronchoscopy, in paediatric patients with tracheobronchial foreign bodies undetected by plain chest radiography.Methods:Plain chest radiography was initially performed in 40 children with suspected foreign body aspiration. Computed tomography virtual bronchoscopy was performed in the 20 in whom chest radiography appeared normal. Virtual bronchoscopic images were obtained. All patients underwent rigid bronchoscopy performed by an otolaryngologist blinded to the computed tomography virtual bronchoscopy findings, within 24 hours. Virtual bronchoscopic findings were then compared with the results of rigid bronchoscopy.Results:In 12 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. In one case, a mucous plug was perceived as a foreign body on virtual bronchoscopy. In another case, a minute foreign body was missed on virtual bronchoscopy. The following parameters were calculated: sensitivity, 92.3 per cent; specificity, 85.7 per cent; validity, 90 per cent; positive likelihood ratio, 6.45; and negative likelihood ratio, 0.089.Conclusion:In the presence of a positive clinical diagnosis and negative chest radiography, computed tomography virtual bronchoscopy must be considered in all cases of tracheobronchial foreign body aspiration, in order to avoid needless rigid bronchoscopy. Computed tomography virtual bronchoscopy is particularly useful in screening cases of occult foreign body aspiration, as it has high sensitivity, specificity and validity.

scholarly journals Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Erol Karaaslan ◽  
Turan Yıldız
Keyword(s):  
Intensive Care ◽  
Foreign Body ◽  
Anesthetic Management ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Laryngeal Edema ◽  
Postoperative Intensive Care ◽  
Operative Complications ◽  
Tracheobronchial Foreign Body ◽  
Post Operative Complications

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 distress. Mean duration of anesthesia was 44.40±14.72 min. Of the 81 patients, 18 (22.2%) were transferred to ICU and 63 (77.8%) patients were transferred to the ward postoperatively. Of the patients transferred to the ICU, 5 of them required mechanical ventilation. Some peri and postoperative complications, desaturation (n=16; 19.7%; p=0.001), mucosal bleeding (n=6; 7.4%; p=0.02), laryngeal edema (n=11; 13.6%; p<0.001), laryngospasm (n=13; 16.3%; p<0.001), were affected the frequency of intensive care transfer. Conclusion: Bronchoscopy with general anesthesia remains the golden standard for the management of tracheobronchial FBA. In such patients, a combination consisting of a detailed preoperative clinical evaluation of the patient, selection of short-acting anesthetic agents with minimal side effects for the induction and maintenance of anesthesia, and the administration of controlled ventilation can be recommended. Additionally, early diagnosis of peri- and post-operative complications, prediction of postoperative ICU requirement, and a close cooperation of anesthesiologists and surgeons are highly important. doi: https://doi.org/10.12669/pjms.35.6.1225 How to cite this:Karaaslan E, Yildiz T. Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration. Pak J Med Sci. 2019;35(6):1592-1597. doi: https://doi.org/10.12669/pjms.35.6.1225 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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