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A retrospective analysis of our anesthesia experience in rigid bronchoscopy interventions in pediatric patients due to foreign body aspiratıons in tracheobranchial system

Year 2015, Volume: 7 Issue: 1, 1 - 7, 01.04.2015

Abstract

Aim: Foreign body aspirations FDA are one of the major problems in pediatric emergency services. The objective of this study is to explore the relations between the preferred anesthesia method and common complications emerging under rigid bronchoscope RB in children exposed to FDA along with their preoperative history retrospectively. Methods: RB based upon the diagnosis or any suspicion of FDA between October 2013 and January 2015. Result: Gender distributions were 68.6% male and 31.4% female. Mean age was 2.72 ± 2.51 years. Most common symptoms were cough and dyspnea 86.2% and 58.8% respectively . Distributions of radiological findings were as follows: normal view 29.4%, obstructive emphysema 23.5% and atelectasia 23.5 %. Most of the substances achieved were composed of organic materials during bronchoscope. Placements of the foreign bodies were on the left bronchial and righ bronchial trees 31.3% and 33.4% respectively. Spontaneous ventilation SV in 6 cases where the proximal localization of the FB, in other 45 cases Manual intermittent positive pressure ventilation using a manual neuromuscular blocking MIPPV was prefered. On the both ventilation methods, desaturation, arrhythmia and broncholaryngeal spasm were complications occurred during anesthesia. None of the patients were found mortality. Conclusion: FDA is known as an important life-threatening situation. Therefore, it is substantial to initiate bronchoscope process immediately by assigning the convenient anesthesia method referring to the placement of the foreign body and general situation of the patient in collaboration with anesthesiologist and bronchoscopy performer that will eventually lead future promising results in decreasing mortality.

References

  • Sırmalı M, Türüt H, Kısacık E, Aydın E, Kaya S, Taştepe İ. Çocukluk çağı trakeobronşial yabancı cisim aspirasyonları. Tıp Araştırmaları Dergisi 2005;3(2):8-12
  • Fidkowski CW, Zheng H, Firth PG The anesthet- ic considerations of tracheobronchial foreign bodies in children: A literature review of 12979 cases. Anesth Analg 2010; 11(4):1016-1025.
  • Chiu CY, Wong KS, Lai SH, Hsia SH, Wu CT. Factors predicting early diagnosis of foreign body aspiration in children. Pediatr Emerg Care 2005; 21:161 -164.
  • Mantel K, Butenand I. Tracheabronchial foreign aspiration in childhood. A report on 224 cases. Eur J Pediatr 1986;145:211-216.
  • Zur KB, Litman RS. Pediatric airway foreign body retrieval: surgical and anesthetic per- spectives. Paediatr Anaesth. 2009; 19(Suppl 1):109-117.
  • Martinot A, Marquette CH, Ramon P, Leclerc F. Foreign body aspiration in childhood: man- agement algorithm. Eur J Emerg Med. 2000; 7:163-165.
  • Farrel P. Rigid broncoscopy for foreign body removal: anaesthesia and ventilation. Ped An- esthesia 2004;14:84-89.
  • Swanson KL, Edell ES. Tracheobronchial foreign bodies. Chest Surg Clin N Am 2001;11:861-72.
  • Pinzoni F, Boniotti C, Molinaro SM, Baraldi A, Berlucchi M. Inhaled foreign bodies in pediat- ric patients: review of personal experience. Int J Otorhibolaryngol 2007; 71(12):1897-1903
  • Pekcan S, Aslan AT. Çocukluk çağında yabancı cisim aspirasyonları. Turkısh J Pediatr Dis. 2010;4(2):119-128
  • Boufersaoui A, Smati L, Benhalla KN et al. Foreign body aspiration in children: experience from 2624 patients. Int J Otorhinolaryngol 2013;77(10):1683-1688
  • Shivakumar AM, Naik AS, Prashanth KB, Shetty KD, Praveen DS. Tracheobronchial foreign bod- ies. Indian J Pediatr 2003;70(10):793-797
  • Öncel M, Metin B. Trakeobronşial yabancı cis- imler. Selçuk Pediatri 2013;1(2):143-147
  • Liman TŞ, Eliçora A, Topçu S. Yabancı cisim aspirasyonları ve özafagus yabancı cisimleri. Toraks cerrahi bülteni 2012; 16:94-103
  • Yadav SP, Singh J, Aggarwal N, Goel A. Airway foreign bodies in children: experience of 132 cases. Singapore Med J 2007;48(9).850-853
  • Aytaç A, Yurdakul Y, İkizler C. Inhalation of for- eign bodies in children. Report of 500 cases. J Thorac Cardiovasc Surg 1977;74:145-151
  • Tamiru T, Gray PE, Pollock JD. An alternative method of managament of pediatric air- way foreign bodies in the absence of rigid bronchoscopy. Int J Pediatr Otorhinolaryngol 2013;77(4):480-482
  • Mehta D, Mehta C, Bansal S, Singla S, Tangri N. Flexible bronchoscopic removal of a three piece foreign body from a child’s bronchus. Australas Med J 2012;5(4):227-230
  • Cavel O, Bergeron M, Garel L, Arcand P, Froe- hlich P. Questioning the legitimacy of rigid bronchoscopy as a tool for establishing the diagnosis of a bronchial foreign body. Int J Pediatr Otorhinolaryngol 2012;76(2):194-201
  • Öç B, Arun O, Öncel M, Duman A. Trakeo- bronşial sistemdeki yabancı cisimlerde anestezi uygulaması. Archives Medical Review Journal 2014;23(2):328-344
  • Litman RS, Ponnuri J, Trogan I. Anesthesia for tracheal or bronchial foreign body removal in children: An analysis of ninety four cases. Anesth Analg 2000;91:1389-1391
  • 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. An- esth Analg 2009;109(4):1079-1084
  • Soodan A, Pawar D, Subramanium R. Anes- thesia for removal of inhaled foreign bodies in children. Paediatr Anesth 2004;14(11):947-952
  • Chen K, Shen X. Dexmedetomidine and propofol total intravenous anesthesia for airway foreign body removal. Ir J Med Sci 2014;183(3):481-484
  • Shen X, Hu CB, Ye M, Chen YZ. Propofol remifentanil intravenous anesthesia and spontaneous ventilation for airway foreign body removal in children with preoperative respiratory impairment. Paediatr Anaesth 2012;22(12):1166-1170
  • Chai J, Wu XY, Han N, Wang LY, Chen WM. A retrospective study of anesthesia during rigid bronchoscopy for airway foreign body removal in children: propofol and sevoflurane with spontaneous ventilation. Paediatr Anesth 2014;24(10):1031-1036
  • Ansermino JM, Magruder W, Dosani M. Spontaneous respiration during intravenous anesthesia in children. Curr Opin Anaesthesiol 2009;22:383-387
  • Soysal O, Kuzucu A, Ulutas H. Tracheobron- chial foreign body aspiration: a continuing challenge. Otolaryngol Head Neck Surg 2006; 135:223-226
  • Zhang X, Li W, Chen Y. Postoperative adverse respiratory events in prescholl patients with in- haled foreign bodies: an analysis of 505 cases.
  • Yıldırım M, Doğusoy I, Okay T, Yaşaroğlu M, Demirbağ H, Aydemir B. ve ark. Trakeobronşial yabancı cisimler. Türk Göğüs Kalp Damar Cer- rahisi Dergisi 2003;11(4):228-231
  • Çobanoğlu U, Yalçınkaya İ. Trakeobronşial yabancı cisim aspirasyonları. Ulus Travma Acil Cerrahi Derg 2009;15(5):493-499.

Trakeobronşial sisteme yabancı cisim aspirasyonu olan pedatrik olgularda uygulanan rijit bronkopi işleminde anestezi deneyimlerimizin retrospektif analizi

Year 2015, Volume: 7 Issue: 1, 1 - 7, 01.04.2015

Abstract

Amaç: Çocuklarda yabancı cisim aspirasyonu YCA sık olarak görülen acillerdendir. Bu çalışmada, YCA nedeniyle rijit bronkoskopi RB yapılan çocukların demografik bilgileri, bronkoskopide seçilen anestezi yöntemi ve oluşan komplikasyonların incelemesi 41 amaçlanmıştır. Metod: Ekim 2013 ile Ocak 2015 tarihleri arasında YCA şüphesi veya tanısı nedeniyle RB 43 yapılan 51 hasta incelenmiştir. Bulgular: Hastaların %68.6'sı erkek, %31.4'ü kız, yaş ortalaması 2,72±2.51 yıldı. En sık görülen semptomlar; %86.2 öksürük ve %58.8 dispne idi. Radyolojik bulguların dağılımı ise %29.4 normal görünüm, %23.5 obstrüktif amfizem ve %23.5 atelektazi idi. Bronkoskopi ile çıkarılan YC'lerin çoğunu organik materyaller oluşturmaktaydı. YC'ler sırasıyla %31.3 sol bronşial ağaç, %33.4 de sağ bronşial ağaçta idi. YC'in proksimal yerleşimli olduğu 6 olguda spontan ventilasyo n SV yöntemi, diğer 45 olguda nöromuskuler bloker kullanılarak Manuel intermittant pozitif pressure ventilasyon MIPPV tercih edildi. Her iki ventilasyon yönteminde desatürasyon, aritmi ve bronşiolaringeal spazm, anestezi sırasında meydana gelen komplikasyonlardı. Hastaların hiçbirisinde mortaliteye rastlanmadı. Sonuç: Çocuklarda YCA'larının hayatı tehdit eden bir durum olduğunu, bronkoskopinin derhal yapılması gerektiğini, anestezistin; hastanın genel durumu, YC'in yerleşimine göre uygun anestezi yöntemini seçmesi gerektiğini ve bu konuda anestezist ile bronkoskopistin işbirliği içinde olmasının mortalite oranını azaltacağı düşünülmüştür.

References

  • Sırmalı M, Türüt H, Kısacık E, Aydın E, Kaya S, Taştepe İ. Çocukluk çağı trakeobronşial yabancı cisim aspirasyonları. Tıp Araştırmaları Dergisi 2005;3(2):8-12
  • Fidkowski CW, Zheng H, Firth PG The anesthet- ic considerations of tracheobronchial foreign bodies in children: A literature review of 12979 cases. Anesth Analg 2010; 11(4):1016-1025.
  • Chiu CY, Wong KS, Lai SH, Hsia SH, Wu CT. Factors predicting early diagnosis of foreign body aspiration in children. Pediatr Emerg Care 2005; 21:161 -164.
  • Mantel K, Butenand I. Tracheabronchial foreign aspiration in childhood. A report on 224 cases. Eur J Pediatr 1986;145:211-216.
  • Zur KB, Litman RS. Pediatric airway foreign body retrieval: surgical and anesthetic per- spectives. Paediatr Anaesth. 2009; 19(Suppl 1):109-117.
  • Martinot A, Marquette CH, Ramon P, Leclerc F. Foreign body aspiration in childhood: man- agement algorithm. Eur J Emerg Med. 2000; 7:163-165.
  • Farrel P. Rigid broncoscopy for foreign body removal: anaesthesia and ventilation. Ped An- esthesia 2004;14:84-89.
  • Swanson KL, Edell ES. Tracheobronchial foreign bodies. Chest Surg Clin N Am 2001;11:861-72.
  • Pinzoni F, Boniotti C, Molinaro SM, Baraldi A, Berlucchi M. Inhaled foreign bodies in pediat- ric patients: review of personal experience. Int J Otorhibolaryngol 2007; 71(12):1897-1903
  • Pekcan S, Aslan AT. Çocukluk çağında yabancı cisim aspirasyonları. Turkısh J Pediatr Dis. 2010;4(2):119-128
  • Boufersaoui A, Smati L, Benhalla KN et al. Foreign body aspiration in children: experience from 2624 patients. Int J Otorhinolaryngol 2013;77(10):1683-1688
  • Shivakumar AM, Naik AS, Prashanth KB, Shetty KD, Praveen DS. Tracheobronchial foreign bod- ies. Indian J Pediatr 2003;70(10):793-797
  • Öncel M, Metin B. Trakeobronşial yabancı cis- imler. Selçuk Pediatri 2013;1(2):143-147
  • Liman TŞ, Eliçora A, Topçu S. Yabancı cisim aspirasyonları ve özafagus yabancı cisimleri. Toraks cerrahi bülteni 2012; 16:94-103
  • Yadav SP, Singh J, Aggarwal N, Goel A. Airway foreign bodies in children: experience of 132 cases. Singapore Med J 2007;48(9).850-853
  • Aytaç A, Yurdakul Y, İkizler C. Inhalation of for- eign bodies in children. Report of 500 cases. J Thorac Cardiovasc Surg 1977;74:145-151
  • Tamiru T, Gray PE, Pollock JD. An alternative method of managament of pediatric air- way foreign bodies in the absence of rigid bronchoscopy. Int J Pediatr Otorhinolaryngol 2013;77(4):480-482
  • Mehta D, Mehta C, Bansal S, Singla S, Tangri N. Flexible bronchoscopic removal of a three piece foreign body from a child’s bronchus. Australas Med J 2012;5(4):227-230
  • Cavel O, Bergeron M, Garel L, Arcand P, Froe- hlich P. Questioning the legitimacy of rigid bronchoscopy as a tool for establishing the diagnosis of a bronchial foreign body. Int J Pediatr Otorhinolaryngol 2012;76(2):194-201
  • Öç B, Arun O, Öncel M, Duman A. Trakeo- bronşial sistemdeki yabancı cisimlerde anestezi uygulaması. Archives Medical Review Journal 2014;23(2):328-344
  • Litman RS, Ponnuri J, Trogan I. Anesthesia for tracheal or bronchial foreign body removal in children: An analysis of ninety four cases. Anesth Analg 2000;91:1389-1391
  • 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. An- esth Analg 2009;109(4):1079-1084
  • Soodan A, Pawar D, Subramanium R. Anes- thesia for removal of inhaled foreign bodies in children. Paediatr Anesth 2004;14(11):947-952
  • Chen K, Shen X. Dexmedetomidine and propofol total intravenous anesthesia for airway foreign body removal. Ir J Med Sci 2014;183(3):481-484
  • Shen X, Hu CB, Ye M, Chen YZ. Propofol remifentanil intravenous anesthesia and spontaneous ventilation for airway foreign body removal in children with preoperative respiratory impairment. Paediatr Anaesth 2012;22(12):1166-1170
  • Chai J, Wu XY, Han N, Wang LY, Chen WM. A retrospective study of anesthesia during rigid bronchoscopy for airway foreign body removal in children: propofol and sevoflurane with spontaneous ventilation. Paediatr Anesth 2014;24(10):1031-1036
  • Ansermino JM, Magruder W, Dosani M. Spontaneous respiration during intravenous anesthesia in children. Curr Opin Anaesthesiol 2009;22:383-387
  • Soysal O, Kuzucu A, Ulutas H. Tracheobron- chial foreign body aspiration: a continuing challenge. Otolaryngol Head Neck Surg 2006; 135:223-226
  • Zhang X, Li W, Chen Y. Postoperative adverse respiratory events in prescholl patients with in- haled foreign bodies: an analysis of 505 cases.
  • Yıldırım M, Doğusoy I, Okay T, Yaşaroğlu M, Demirbağ H, Aydemir B. ve ark. Trakeobronşial yabancı cisimler. Türk Göğüs Kalp Damar Cer- rahisi Dergisi 2003;11(4):228-231
  • Çobanoğlu U, Yalçınkaya İ. Trakeobronşial yabancı cisim aspirasyonları. Ulus Travma Acil Cerrahi Derg 2009;15(5):493-499.
There are 31 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Aykut Urfalıoğlu This is me

Mahmut Arslan This is me

Gökçe Gişi This is me

Bora Bilal This is me

Ali Erdal Karakaya This is me

Hafize Öksüz This is me

Publication Date April 1, 2015
Published in Issue Year 2015 Volume: 7 Issue: 1

Cite

Vancouver Urfalıoğlu A, Arslan M, Gişi G, Bilal B, Karakaya AE, Öksüz H. Trakeobronşial sisteme yabancı cisim aspirasyonu olan pedatrik olgularda uygulanan rijit bronkopi işleminde anestezi deneyimlerimizin retrospektif analizi. Maltepe tıp derg. 2015;7(1):1-7.