scholarly journals Anesthesia during rigid bronchoscopy for tracheobronchial foreign body removal in children：A Systematic Review and Meta-analysis of Comparative Studies

2021 ◽  
Author(s):  
Weiping wang ◽  
Shangyingying Li ◽  
Hui Liu ◽  
Qin Tian ◽  
Hang Chen ◽  
...  
Keyword(s):  
Foreign Body ◽  
Meta Analysis ◽  
Body Movement ◽  
Rigid Bronchoscopy ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Foreign Body Removal ◽  
Volatile Anesthesia ◽  
Tracheobronchial Foreign Body ◽  
Ventilation Modes

Background: There is no consensus regarding the optimal anesthetic approach to rigid bronchoscopy in children suffering from tracheobronchial FBA. We performed this meta-analysis to assess the efficacy and safety of the different anesthesia agents and ventilation modes for tracheobronchial foreign body removal via rigid bronchoscopy in young children. Methods: A systematic search of three major databases for all relevant articles. A meta-analysis was performed to analyze the data. Results: Four trials for evaluating different anesthetics and six trials for evaluating two kinds of ventilation modes were found. Compared with the sevoflurane-based volatile anesthesia group , the rate of perioperative complications included hypoxemia (OR, 2.07; 95% CI, 1.38–3.11; P=0.0004; I2 = 0%), apnea (OR, 2.74; 95% CI, 1.11–6.78; P = 0.03; I2 = 60%), laryngospasm (OR, 2.89; 95% CI, 1.67–4.98; P=0.0001; I2 = 0%), cough/bucking (OR, 2.93; 95% CI, 1.86–4.63; P<0.00001; I2 = 0%), and body movement (OR, 3.51; 95% CI, 2.03–6.09; P<0.00001; I2 = 0%) were significantly increased in the propofol-based total intravenous anesthesia and the duration of operation were longer in the Group Prop. Compared with the control ventilation group , the incidences of laryngospasm (OR, 0.16; 95% CI, 0.05–0.56; P=0.004; I2 = 54%), apnea (OR, 0.21; 95% CI, 0.09–0.50; P=0.0004; I2 = 0%), and cough/bucking (OR, 0.03; 95% CI, 0.01–0.10; P<0.00001; I2 = 41%) increased in the spontaneous ventilation group and the duration of operationand emergence from anesthesia significantly prolonged in the Group SV. Conclusions: Our meta-analysis suggests that sevoflurane-based volatile anesthesia was superior to propofol-based total intravenous anesthesia for the management of foreign body aspiration in children. There is still no strong evidence indicated that one ventilation technique was superio

scholarly journals ANAESTHTIC CONSIDERATION OF TRACHEOBRONCHIAL FOREIGN BODY REMOVAL VIA RIGID BRONCHOSCOPY.

2018 ◽  
Vol 6 (11) ◽  
pp. 600-602
Author(s):  
Vishaka H ◽  
◽  
Mirowais ahmed ◽  
Vennel Jessey ◽  
Ankita joshi ◽  
...  
Keyword(s):  
Foreign Body ◽  
Rigid Bronchoscopy ◽  
Foreign Body Removal ◽  
Tracheobronchial Foreign Body

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 Challenges in Management of Tracheobronchial Foreign Bodies with Delayed Presentation: An Institutional Experience

2021 ◽  
Author(s):  
Darwin Kaushal ◽  
Amit Goyal ◽  
Kapil Soni ◽  
Bikram Choudhury ◽  
Nithin Prakasan Nair ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Preoperative Planning ◽  
Rigid Bronchoscopy ◽  
Delayed Presentation ◽  
Betel Nut ◽  
Key Factors ◽  
Tracheobronchial Foreign Body ◽  
Institutional Experience ◽  
Definitive Management

Abstract Introduction Airway foreign bodies are emergencies involving multidisciplinary departments like Pediatrics, Aneasthesiology and Otorhinolaryngology. It is always a challenge to diagnose and manage patients who present late to our emergencies. Objective In the present study, we aim to analyze the various challenges faced during the management of tracheobronchial foreign bodies with delayed presentation. Methods A retrospective hospital record-based analysis of patients who presented to us with tracheobronchial foreign bodies from January 2017 to February 2020 was performed. All patients until the age of 16 years old were included in the present study. We assessed the demographics, preoperative, intraoperative and postoperative data of the patients. Results Seventeen patients were analyzed in the study. Among these, 44.4% of the patients had delayed presentation (> 1 month). The majority of the patients had an organic foreign body (Supari or betel nut). All patients underwent rigid bronchoscopy, followed by optical forceps-assisted removal of the foreign body. A total of 82% of the patients had granulations around the foreign body. Conclusion Management of delayed presentation tracheobronchial foreign body is a big challenge for Otorhinolaryngologists. The key factors for preventing complications in the definitive management of tracheobronchial foreign bodies are preoperative planning, multi-discipline teamwork, surgeon expertise and technique.

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