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A time series observation of Chinese children undergoing rigid bronchoscopy for an inhaled foreign body: 3,149 cases in 1991-2010.

Zhang X, Li WX, Cai YR - Chin. Med. J. (2015)

Bottom Line: The survey results confirmed that hypoxemia remains the most common postoperative complication in different periods.Both controlled ventilation and spontaneous ventilation were effective during the RB extraction of the foreign body at our hospital in the modern technique period.An active respiratory symptom was commonly seen in the groups with negative findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China.

ABSTRACT

Background: In China, tracheobronchial foreign body (TFB) aspiration, a major cause of emergency episode and accident death in children, remains a challenge for anesthetic management. Here, we share our experience and discuss the anesthetic consideration and management of patients with TFB aspiration.

Methods: This was a single-institution retrospective study in children with an inhaled foreign body between 1991 and 2010 that focused on the complications following rigid bronchoscopy (RB). Data including the clinical characteristics of patients and TFB, anesthetic method, and postoperative severe complications were analyzed by different periods.

Results: During the 20-year study period, the charts of 3149 patients who underwent RB for suspected inhaled TFB were reviewed. There were 2079 male and 1070 female patients (1.94:1). A nut (84%) was the most commonly inhaled object. The study revealed a 9% (n = 284) overall rate of severe postoperative complications related to severe hypoxemia, laryngeal edema, complete laryngospasm, pneumothorax, total segmental atelectasis, and death with incidences of 3.2%, 0.9%, 1.3%, 0.3%, 0.3%, and 0.1%, respectively. The rates of preoperative airway impairment, negative findings of TFB, and adverse postoperative events have been on the rise in the past 5 years.

Conclusions: The survey results confirmed that hypoxemia remains the most common postoperative complication in different periods. Both controlled ventilation and spontaneous ventilation were effective during the RB extraction of the foreign body at our hospital in the modern technique period. An active respiratory symptom was commonly seen in the groups with negative findings.

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Time between tracheobronchial foreign body aspiration and presentation at the Eye and ENT Hospital.
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Figure 4: Time between tracheobronchial foreign body aspiration and presentation at the Eye and ENT Hospital.

Mentions: Quantitative variables are presented as mean ± standard deviation (SD); qualitative data are expressed as a percentage of the total patient number. We created a histogram chart to show the quantity of surgery and general anesthesia number in aspirated patients who underwent RB [Figure 2] along with a comparison of various postoperative adverse effects during the four sequential periods [Figure 3]. We also explored the percentages of TFB (characteristic, retention) and surgical duration using pie charts [Figures 4–6]. The line charts in Figure 7 show the rate of increasing preoperative airway impairment, negative TFB findings and postoperative adverse events over a continuous interval (2005–2010) (n = 1971). The incidence of severe postoperative complications among patients with inhaled TFB according to ventilation mode (2005–2010) is shown. Fisher's exact test was used to examine categorical variables, and P < 0.05 was considered as statistically significant.


A time series observation of Chinese children undergoing rigid bronchoscopy for an inhaled foreign body: 3,149 cases in 1991-2010.

Zhang X, Li WX, Cai YR - Chin. Med. J. (2015)

Time between tracheobronchial foreign body aspiration and presentation at the Eye and ENT Hospital.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836255&req=5

Figure 4: Time between tracheobronchial foreign body aspiration and presentation at the Eye and ENT Hospital.
Mentions: Quantitative variables are presented as mean ± standard deviation (SD); qualitative data are expressed as a percentage of the total patient number. We created a histogram chart to show the quantity of surgery and general anesthesia number in aspirated patients who underwent RB [Figure 2] along with a comparison of various postoperative adverse effects during the four sequential periods [Figure 3]. We also explored the percentages of TFB (characteristic, retention) and surgical duration using pie charts [Figures 4–6]. The line charts in Figure 7 show the rate of increasing preoperative airway impairment, negative TFB findings and postoperative adverse events over a continuous interval (2005–2010) (n = 1971). The incidence of severe postoperative complications among patients with inhaled TFB according to ventilation mode (2005–2010) is shown. Fisher's exact test was used to examine categorical variables, and P < 0.05 was considered as statistically significant.

Bottom Line: The survey results confirmed that hypoxemia remains the most common postoperative complication in different periods.Both controlled ventilation and spontaneous ventilation were effective during the RB extraction of the foreign body at our hospital in the modern technique period.An active respiratory symptom was commonly seen in the groups with negative findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China.

ABSTRACT

Background: In China, tracheobronchial foreign body (TFB) aspiration, a major cause of emergency episode and accident death in children, remains a challenge for anesthetic management. Here, we share our experience and discuss the anesthetic consideration and management of patients with TFB aspiration.

Methods: This was a single-institution retrospective study in children with an inhaled foreign body between 1991 and 2010 that focused on the complications following rigid bronchoscopy (RB). Data including the clinical characteristics of patients and TFB, anesthetic method, and postoperative severe complications were analyzed by different periods.

Results: During the 20-year study period, the charts of 3149 patients who underwent RB for suspected inhaled TFB were reviewed. There were 2079 male and 1070 female patients (1.94:1). A nut (84%) was the most commonly inhaled object. The study revealed a 9% (n = 284) overall rate of severe postoperative complications related to severe hypoxemia, laryngeal edema, complete laryngospasm, pneumothorax, total segmental atelectasis, and death with incidences of 3.2%, 0.9%, 1.3%, 0.3%, 0.3%, and 0.1%, respectively. The rates of preoperative airway impairment, negative findings of TFB, and adverse postoperative events have been on the rise in the past 5 years.

Conclusions: The survey results confirmed that hypoxemia remains the most common postoperative complication in different periods. Both controlled ventilation and spontaneous ventilation were effective during the RB extraction of the foreign body at our hospital in the modern technique period. An active respiratory symptom was commonly seen in the groups with negative findings.

Show MeSH
Related in: MedlinePlus