Scientific Online Resource System

International Bulletin of Otorhinolaryngology

Anesthetic Techniques and Complications for Airway Foreign Body Removal in Children

Ts. Marinov, M. Belitova, T. Popov, J. Rangachev, O. Stoyanov, D. Popova

Abstract

Theoretical basis: Aspiration of foreign bodies by children is a common problem around the world. Asphyxiation from inhaled foreign bodies is a leading cause of accidental death among children younger than 4 years. The Aim of the study is to determine different anesthetic techniques and complications for airway foreign body removal in children. Results: Most patients with aspirated foreign bodies are children younger than 3 years. Most of the aspirated foreign bodies are organic materials. Nuts (especially peanuts) and seeds (mainly sunflower and watermelon) are the most commonly aspirated foreign bodies reported in almost all studies. A history of a witnessed choking event is highly suggestive of an acute aspiration. Major iatrogenic complications were specified in 21 studies with 9437 children with aspirated foreign bodies. These complications included severe laryngeal edema or bronchospasm, pneumothorax, pneumomediastinum, cardiac arrest, tracheal or bronchial laceration, and hypoxic brain damage. Mortality data were obtained from 26 articles with 43 deaths among 10,236 children (0.42%) with aspirated foreign bodies. Anesthetic considerations encompass preoperative assessment, management techniques for flexible or rigid bronchoscopy, and postbronchoscopic disposition. Conclusion: Aspiration of a foreign body is a potentially lethal event. Although several anesthetic techniques are effective for managing children with foreign body aspiration, there is no consensus from the literature as to which technique is optimal.

Keywords

Foreign body, anesthetic techniques, complications

Full Text


References

Clerf LH. Historical aspects of foreign bodies in the air and food passages. South Med J 1975; 68:1449–54.

Cohen S, Avital A, Godfrey S, Gross M, Kerem E, Springer C. Suspected foreign body inhalation in children: what are the indications for bronchoscopy? J Pediatr 2009; 155:276–80.

Gregori D, Salerni L, Scarinzi C, Morra B, Berchialla P, Snidero S, Corradetti R, Passali D, Klaus A, Isidor H, Gernot S, Jan B, Bernard B, Karchev T, Tzolov T, Ranko M, Lana K, Ivo S, Mirko T, Caye-Thomasen P, Anne P, Volker J, Onder G, Simasko N, Matilda C, Christopoulos I, Passà li GC, Passà li F, Damiani V, MieczysÅaw C, Dorin S, Gheorghe DC, Janka J, Miha Z, Ales G, Ales M, Lorenzo R, Javier C, Pontus S, Philippe P, Ahmed C, Metin OT, Ozden CA, Riza D, John G, Peter R, Rupert O. Foreign bodies in the upper airways causing complications and requiring hospitalization in children aged 0–14 years: results from the ESFBI study. Eur Arch Otorhinolaryngol 2008;265:971–8

Higuchi O, Adachi Y, Ichimaru T, Asai M, Kawasaki K. Foreign body aspiration in children: a nationwide survey in Japan. Int J Pediatr Otorhinolaryngol 2009; 73:659–61.

Tang LF, Xu YC, Wang YS, Wang CF, Zhu GH, Bao XE, Lu MP, Chen LX, Chen ZM. Airway foreign body removal by flexible bronchoscopy: experience with 1027 children during 2000–2008. World J Pediatr 2009; 5:191–5.

Ciftci AO, Bingol-Kologlu M, Senocak ME, Tanyel FC, Buyukpamukcu N. Bronchoscopy for evaluation of foreign body aspiration in children. J Pediatr Surg 2003; 38:1170–6.

Emir H, Tekant G, Besik C, Elicevik M, Senyuz OF, Buyukunal C, Sarimurat N, Yeker D. Bronchoscopic removal of tracheobroncheal foreign bodies: value of patient history and timing. Pediatr Surg Int 2001; 17:85–7.

Mahafza T, Khader Y. Aspirated tracheobronchial foreign bodies: a Jordanian experience. Ear Nose Throat J 2007; 86:107–10

Roh JL, Hong SJ. Lung recovery after rigid bronchoscopic removal of tracheobronchial foreign bodies in children. Int J Pediatr Otorhinolaryngol 2008; 72:635–41.

Shivakumar AM, Naik AS, Prashanth KB, Shetty KD, Praveen DS. Tracheobronchial foreign bodies. Indian J Pediatr 2003; 70: 793–7.

Tan HK, Brown K, McGill T, Kenna MA, Lund DP, Healy GB. Airway foreign bodies (FB): a 10-year review. Int J Pediatr Otorhinolaryngol 2000; 56:91–9.

Aydogan LB, Tuncer U, Soylu L, Kiroglu M, Ozsahinoglu C. Rigid bronchoscopy for the suspicion of foreign body in the airway. Int J Pediatr Otorhinolaryngol 2006; 70:823–8.

Bittencourt PF, Camargos PA, Scheinmann P, de Blic J. Foreign body aspiration: clinical, radiological findings and factors associated with its late removal. Int J Pediatr Otorhinolaryngol 2006; 70:879–84.

Brkic F, Delibegovic-Dedic S, Hajdarovic D. Bronchoscopic removal of foreign bodies from children in Bosnia and Herzegovina: experience with 230 patients. Int J Pediatr Otorhinolaryngol 2001; 60:193–6.

Hasdiraz L, Oguzkaya F, Bilgin M, Bicer C. Complications of bronchoscopy for foreign body removal: experience in 1,035 cases. Ann Saudi Med 2006; 26:283–7.

Heyer CM, Bollmeier ME, Rossler L, Nuesslein TG, Stephan V, Bauer TT, Rieger CH. Evaluation of clinical, radiologic, and laboratory prebronchoscopy findings in children with suspected foreign body aspiration. J Pediatr Surg 2006; 41:1882–8.

Kadmon G, Stern Y, Bron-Harlev E, Nahum E, Battat E, Schonfeld T. Computerized scoring system for the diagnosis of foreign body aspiration in children. Ann Otol Rhinol Laryngol 2008; 117:839–43.

Karakoc F, Karadag B, Akbenlioglu C, Ersu R, Yildizeli B, Yuksel M, Dagli E. Foreign body aspiration: what is the outcome? Pediatr Pulmonol 2002; 34:30–6.

Roda J, Nobre S, Pires J, Estкvгo MH, Fйlix M. Foreign bodies in the airway: a quarter of a century’s experience. Rev Port Pneumol 2008; 14:787–802.

Shubha AM, Das K. Tracheobronchial foreign bodies in infants. Int J Pediatr Otorhinolaryngol 2009; 73:1385–9.

Skoulakis CE, Doxas PG, Papadakis CE, Proimos E, Christodoulou P, Bizakis JG, Velegrakis GA, Mamoulakis D, Helidonis ES. Bronchoscopy for foreign body removal in children. A review and analysis of 210 cases. Int J Pediatr Otorhinolaryngol 2000; 53:143–8.

Tokar B, Ozkan R, Ilhan H. Tracheobronchial foreign bodies in children: importance of accurate history and plain chest radiography in delayed presentation. Clin Radiol 2004; 59:609–15.

Tomaske M, Gerber AC, Stocker S, Weiss M. Tracheobronchial foreign body aspiration in children–diagnostic value of symptoms and signs. Swiss Med Wkly 2006; 136:533–8.

Yadav SP, Singh J, Aggarwal N, Goel A. Airway foreign bodies in children: experience of 132 cases. Singapore Med J 2007; 48: 850–3.

Ayed AK, Jafar AM, Owayed A. Foreign body aspiration in children: diagnosis and treatment. Pediatr Surg Int 2003; 19:485–8.

Erikзi V, Karaзay S, Arikan A. Foreign body aspiration: a four-years experience. Ulus Travma Acil Cerrahi Derg 2003; 9:45–9.

Kiyan G, Gocmen B, Tugtepe H, Karakoc F, Dagli E, Dagli TE. Foreign body aspiration in children: the value of diagnostic criteria. Int J Pediatr Otorhinolaryngol 2009; 73:963–7.

Divisi D, Di Tommaso S, Garramone M, Di Francescantonio W, Crisci RM, Costa AM, Gravina GL, Crisci R. Foreign bodies aspirated in children: role of bronchoscopy. Thorac Cardiovasc Surg 2007; 55:249–52.

Б. Младенов. Подготовка на дете за анестезия. Практическа Педиатрия 06/2018; 14–18.

Б. Младенов. Рискове при анестезия в детската възраст. Практическа педиатрия 06/2018; 10–14.

Eren S, Balci AE, Dikici B, Doblan M, Eren MN. Foreign body aspiration in children: experience of 1160 cases. Ann Trop Paediatr 2003;23:31–7.

Hui H, Na L, Zhijun CJ, Fugao ZG, Yan S, Niankai ZK, Jingjing CJ. Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body. J Pediatr Surg 2008; 43:718–21.

Mani N, Soma M, Massey S, Albert D, Bailey CM. Removal of inhaled foreign bodies–middle of the night or the next morning?. Int J Pediatr Otorhinolaryngol 2009; 73:1085–9.

Soodan A, Pawar D, Subramanium R. Anesthesia for removal of inhaled foreign bodies in children. Paediatr Anaesth 2004; 14:947–52.

Kumar S, Saxena AK, Kumar M, Rautela RS, Gupta N, Goyal A. Anesthetic management during bronchoscopic removal of a unique, friable foreign body. Anesth Analg 2006; 103:1596–7

Pawar DK. Dislodgement of bronchial foreign body during retrieval in children. Paediatr Anaesth 2000; 10:333–5.




DOI: http://dx.doi.org/10.14748/orl.v15i2.6704

Refbacks

Font Size


|