Abstract
Background: Tracheobronchial foreign body aspiration is an emergency in childhood. Rigid bronchoscopy is used for diagnosis and treatment. In our retrospective study, we aimed to evaluate anesthesia man-agement, age, gender, intraoperative blood pressure, pulse, saturation, intraoperative and postoperative complications, foreign body type and localization and length of hospitalization.
Materials and Methods: The file of 198 pediatric patients who underwent rigid bronchoscopy by pediatric surgery with the diagnosis of foreign body aspiration in Harran University Medical Faculty Hospital be-tween 2016-2018 were retrospectively analyzed. All cases were managed under general anesthesia. The anesthesia management, age, gender, intraoperative blood pressure, pulse, saturation, intraoperative and postoperative complications, foreign body and localization, length of stay were obtained from patient records and retrospectively evaluated.
Results: Localization of foreign bodies were found to be 4.5% in trachea, 48% in right main bronchus and 33.9% in the left main bronchus. 25.3% of foreign bodies were seed, 25.62% were peanuts and 5.62% were organic substances such as beans, needle was removed in 7.6% cases, and toy pieces was removed in 9.6% cases respectively. Low levels of saturation, hypercarbia, arrhythmia, laryngospasm and bron-chospasm were observed as complications of anesthesia.
Conclusions: Foreign body aspiration is an emergency that requires early diagnosis and urgent interven-tion. It is important to be aware of the complications that may occur during anesthesia and momentous to be intervened by an experienced team.
Keywords
References
- 1.Tomaske M, Gerber AC, Weiss M. Anesthesiaandperiinterventional morbidity of rigidbronchoscopyfortracheobronchialforeign body diagnosisandremoval. PedAnesthesia2006;16:123-9.
- 2. Öç B AÖ, Öncel M, Duman A. Trakeobronşial sistemdeki yabancı cisimlerde anestezi uygulaması. Arşiv Kaynak Tarama Dergisi. 2014;23:328-44.
- 3.Soyer T. The role bronchoscopy in thediagnosis of airwaydisease in children. J ThoracDis. 2016;8:3420-6.
- 4. Perez-Frias J, MorenoGaldo A, PerezRuiz E, BarrioGomez De Aguero MI, EscribanoMontaner A et al. Pediatricbronchoscopyguidelines. ArchBronconeumol. 2011;47:350-60. 5. Farrel P. Rigidbroncoscopyforforeign body removal: anesthesiaand ventilation. PedAnesthesia2004;14:84-9.
- 6. Swanson KL, Edell ES. Tracheobronchialforeignbodies. ChestSurg Clin N Am2001;11:861-72.
- 7.Sinha V, Umesh TS, Jha SG.RigidBronchoscopy in PediatricPatientsIndian J Otolaryngol-HeadNeckSurg. (Oct–Dec 2017) 69(4):449–452; doi.org/10.1007/s12070-017-1222-2
- 8.Kendigelen P.Theanaestheticconsideration of tracheobronchialforeign body aspiration in children. J ThoracDis. 2016 Dec; 8(12): 3803–3807. doi: 10.21037/jtd.2016.12.69
- 9. Zhijun C, Fugao Z, Niankai Z, Jingjing C. Therapeuticexperiencefrom 1428 patientswithpediatrictracheobronchialforeign body. J Pediatr Sur 2008;43:718-21.
- 10.Yi-HuiYang, Xin-Gang Zhang, Jian-LiZhangRisk factorsforpreoperativerespiratorycomplicationsin childrenwithTracheobronchialforeignbodies
- 11.Korlacki W, Korecka K, DizielickiJ.Foreign Body Aspiration in children: diagnosticandtherapeutic role of bronchoscopy.PediatrSurgInt (2011) 27:833–837
- 12.Urfalıoğlu A, Arslan M, Gişi G, Bilal B, Karakaya AE, Öksüz H. Trakeobronşial sisteme yabancı cisim aspirasyonu olan pediatrik olgularda uygulanan rijitbronkopi işleminde anestezi deneyimlerimizin retrospektif analizi. Maltepe Tıp Dergisi. 2015;7:1-7.
- 13. Tomaske M, Gerber AC, Weiss M. Anesthesiaandperiinterventionalmorbidity of rigidbronchoscopyfortracheobronchialforeign body diagnosisandremoval. PaediatrAnaesth. 2006;16:123-9.
- 14.Erginel B et al.RıgıdBronchoscopyInTheTreatment Of Foreıgn Body Aspıratıon, J IstFacultyMed 2016; 79: 3
- 15.Kalyanappagol VT, Kulkarni NH, Bidri LH. Management of tracheobronchial foreign body aspirations in paediatric age group - A 10 year retrospective analysis. Indian J Anaesth. 2007;51:20-3.
- 16.Fidkowski CW, Zheng H, Firth PG. The anesthetic considerations of tracheobronchial foreign bodies in children: a literature review of 12,979 cases. Anesth Analg. 2010;111:1016-25.
- 17.Farrell PT. Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation. Paediatr Anaesth. 2004;14:84-9.
- 18.Chen LH, Zhang X, Li SQ, Liu YQ, Zhang TY, Wu JZ. The risk factors for hypoxemia in children younger than 5 years old undergoing rigid bronchoscopy for foreign body removal. Anesth Analg. 2009;109:1079-84.
- 19.. Cai Y, Li W, Chen K. Efficacy and safety of spontaneous ventilation technique using dexmedetomidine for rigid bronchoscopic airway foreign body removal in children. Paediatr Anaesth. 2013;23:1048-53.
- 20. Divisi D, Di Tommaso S, Garramone M, Di Francescantonio W, Crisci RM, Costa AM et al. Foreign bodies aspirated in children: role of bronchoscopy. Thorac Cardiovasc Surg. 2007;55:249-52.
- 21. Korlacki W1, Korecka K, Dzielicki J. Foreign body aspiration in children: diagnostic and therapeutic role of bronchoscopy. Pediatr Surg Int. 2011 Aug;27(8):833-7. doi: 10.1007/s00383-011-2874-8. Epub 2011 Mar 13.
- 22. Zur KB1, Litman RS. Pediatric airway foreign body retrieval: surgical and anesthetic perspectives. Paediatr Anaesth. 2009 Jul;19 Suppl 1:109-17. doi: 10.1111/j.1460-9592.2009.03006.x.
Abstract
Amaç:
Çocukluk çağında trakeobronşial yabancı cisim aspirasyonu acil bir durumdur bu amaçla rijid bronkoskopi tanı ve tedavide kullanılmaktadır. Geriye dönük çalışmamızda anestezi yönetimleri, yaş, cinsiyet, intraoperatif kan basıncı, nabız, satürasyon, intraoperatif ve postoperatif gelişen komplikasyonlar, çıkarılan yabancı cisim ve lokalizasyonu, yatış sürelerini değerlendirilmeyi amaçladık.
Gereç ve yöntem: Harran Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi Ameliyathanesinde2016-2018 yılları arasında yabancı cisim aspirasyonu tanısıyla çocuk cerrahisi tarafından rijid bronkoskopi yapılan 198 pediatrik hastanın dosyaları geriye dönük olarak incelendi. Tüm olgulara genel anestezi uygulandı. Hastaların anestezi yönetimleri, yaş, cinsiyet, intraoperatif kan basıncı, nabız, satürasyon, intraoperatif ve postoperatif gelişen komplikasyonlar, çıkarılan yabancı cisim ve lokalizasyonu, yatış süreleri gibi bilgiler hastane kayıtlarından elde edilerek değerlendirildi.
Bulgular: Yabancı cisimlerin lokalizasyonları trakea (%4.5), sağ ana bronş (%48), sol ana bronş (%33.9) olarak bulundu.Yabancı cisimler hastaların %25.3'uda çekirdek, %10.62’sında fıstık, %5.62’sında fasulye gibi organik maddeler ,%7,6’sında iğne, %9.6’sındaoyuncak parçası çıkartıldı. Anestezi komplikasyonları olarak satürasyon düşüklüğü, hiperkarbi, aritmi, laringospasm ve bronkospazm gözlenmiştir.
Sonuç: Yabancı cisim aspirasyonu erken tanı koyulup acil müdahale edilmesi gereken bir durumdur. Anestezi sırasında oluşabilecek komplikasyonların farkında olmak ve tecrübeli bir ekip tarafından müdahale etmek önemlidir.
Keywords
References
- 1.Tomaske M, Gerber AC, Weiss M. Anesthesiaandperiinterventional morbidity of rigidbronchoscopyfortracheobronchialforeign body diagnosisandremoval. PedAnesthesia2006;16:123-9.
- 2. Öç B AÖ, Öncel M, Duman A. Trakeobronşial sistemdeki yabancı cisimlerde anestezi uygulaması. Arşiv Kaynak Tarama Dergisi. 2014;23:328-44.
- 3.Soyer T. The role bronchoscopy in thediagnosis of airwaydisease in children. J ThoracDis. 2016;8:3420-6.
- 4. Perez-Frias J, MorenoGaldo A, PerezRuiz E, BarrioGomez De Aguero MI, EscribanoMontaner A et al. Pediatricbronchoscopyguidelines. ArchBronconeumol. 2011;47:350-60. 5. Farrel P. Rigidbroncoscopyforforeign body removal: anesthesiaand ventilation. PedAnesthesia2004;14:84-9.
- 6. Swanson KL, Edell ES. Tracheobronchialforeignbodies. ChestSurg Clin N Am2001;11:861-72.
- 7.Sinha V, Umesh TS, Jha SG.RigidBronchoscopy in PediatricPatientsIndian J Otolaryngol-HeadNeckSurg. (Oct–Dec 2017) 69(4):449–452; doi.org/10.1007/s12070-017-1222-2
- 8.Kendigelen P.Theanaestheticconsideration of tracheobronchialforeign body aspiration in children. J ThoracDis. 2016 Dec; 8(12): 3803–3807. doi: 10.21037/jtd.2016.12.69
- 9. Zhijun C, Fugao Z, Niankai Z, Jingjing C. Therapeuticexperiencefrom 1428 patientswithpediatrictracheobronchialforeign body. J Pediatr Sur 2008;43:718-21.
- 10.Yi-HuiYang, Xin-Gang Zhang, Jian-LiZhangRisk factorsforpreoperativerespiratorycomplicationsin childrenwithTracheobronchialforeignbodies
- 11.Korlacki W, Korecka K, DizielickiJ.Foreign Body Aspiration in children: diagnosticandtherapeutic role of bronchoscopy.PediatrSurgInt (2011) 27:833–837
- 12.Urfalıoğlu A, Arslan M, Gişi G, Bilal B, Karakaya AE, Öksüz H. Trakeobronşial sisteme yabancı cisim aspirasyonu olan pediatrik olgularda uygulanan rijitbronkopi işleminde anestezi deneyimlerimizin retrospektif analizi. Maltepe Tıp Dergisi. 2015;7:1-7.
- 13. Tomaske M, Gerber AC, Weiss M. Anesthesiaandperiinterventionalmorbidity of rigidbronchoscopyfortracheobronchialforeign body diagnosisandremoval. PaediatrAnaesth. 2006;16:123-9.
- 14.Erginel B et al.RıgıdBronchoscopyInTheTreatment Of Foreıgn Body Aspıratıon, J IstFacultyMed 2016; 79: 3
- 15.Kalyanappagol VT, Kulkarni NH, Bidri LH. Management of tracheobronchial foreign body aspirations in paediatric age group - A 10 year retrospective analysis. Indian J Anaesth. 2007;51:20-3.
- 16.Fidkowski CW, Zheng H, Firth PG. The anesthetic considerations of tracheobronchial foreign bodies in children: a literature review of 12,979 cases. Anesth Analg. 2010;111:1016-25.
- 17.Farrell PT. Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation. Paediatr Anaesth. 2004;14:84-9.
- 18.Chen LH, Zhang X, Li SQ, Liu YQ, Zhang TY, Wu JZ. The risk factors for hypoxemia in children younger than 5 years old undergoing rigid bronchoscopy for foreign body removal. Anesth Analg. 2009;109:1079-84.
- 19.. Cai Y, Li W, Chen K. Efficacy and safety of spontaneous ventilation technique using dexmedetomidine for rigid bronchoscopic airway foreign body removal in children. Paediatr Anaesth. 2013;23:1048-53.
- 20. Divisi D, Di Tommaso S, Garramone M, Di Francescantonio W, Crisci RM, Costa AM et al. Foreign bodies aspirated in children: role of bronchoscopy. Thorac Cardiovasc Surg. 2007;55:249-52.
- 21. Korlacki W1, Korecka K, Dzielicki J. Foreign body aspiration in children: diagnostic and therapeutic role of bronchoscopy. Pediatr Surg Int. 2011 Aug;27(8):833-7. doi: 10.1007/s00383-011-2874-8. Epub 2011 Mar 13.
- 22. Zur KB1, Litman RS. Pediatric airway foreign body retrieval: surgical and anesthetic perspectives. Paediatr Anaesth. 2009 Jul;19 Suppl 1:109-17. doi: 10.1111/j.1460-9592.2009.03006.x.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 27, 2022 |
| Submission Date | October 17, 2022 |
| Acceptance Date | November 9, 2022 |
| Published in Issue | Year 2022 Volume: 19 Issue: 3 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty