Rigid bronchoscopic extraction of radiolucent foreign bodies in children: outcomes of early intervention

被引：1

作者：

Mubarak Y.S. ^{[1
]}

Mohamed A.H. ^{[2
]}

Kamal Y.A. ^{[1
]}

机构：

[1] Department of Cardiothoracic Surgery, Minia University, Minia

[2] Department of Anesthesiology and Intensive Care Unit, Minia University, Minia

来源：

Indian Journal of Thoracic and Cardiovascular Surgery | 2014年 / 30卷 / 2期

关键词：

Aspiration; Foreign body; Rigid bronchoscopy;

D O I：

10.1007/s12055-014-0279-8

中图分类号：

学科分类号：

摘要：

Objective: The purpose of this study was to evaluate the role of rigid bronchoscopy in diagnosis and treatment of aspirated radiolucent foreign body (FB) in children.; Patients and method: The study was conducted on 150 children with clinical suspicion of radiolucent tracheobronchial FB aspiration, between January 2011 and September 2013. There were 103 (68.7 %) boys and 47 (31.3 %) girls, with a male-to-female ratio of 2.1:1; their age ranged from 4 to 36 months. Removal of aspirated FB was performed under general anesthesia. Patients with favorable outcome were discharged within 24 h.; Results: The most common clinical findings were cough (70 %), wheezing (54 %), diminished breath sound (64 %), fever (42 %), and dyspnea (27.3 %) and cyanosis (22.7 %). Rigid bronchoscopy for aspirated tracheobronchial FBs was positive in 95.3 %. The extracted FB was organic (peanuts and fruits) in 95.8 %, and the most common location for FB was the right main bronchus (49.6 %). The most sensitive clinical findings were cough (71.3 %), and the most specific findings were wheezing (85.7 %). Wheezing was a statistically significant predictor of the positive FB (odds ratio = 7.6, CI = 0.89 to 64.9). There was a statistically insignificant difference in demographic and clinical findings between the two positive groups of bronchial and tracheal FBs. The post-procedural complications were encountered in 7.3 % which included pneumonia (3.3 %), hypoxemia (2.7 %), and pneumothorax (1.3 %). The rate of complications was higher and statistically significant with intravenous anesthesia than with inhalation anesthesia (14.5 versus 3.1 %, respectively).; Conclusion: Removal of radiolucent tracheobronchial FBs in children using rigid bronchoscopy can be performed safely with minimal risks and complications according to type, size, and location of FB. The index of suspicion is raised by careful history and physical examination. © 2014, Indian Association of Cardiovascular-Thoracic Surgeons.

引用

页码：140 / 146

页数：6

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