Essential notes: the anaesthetic management of an inhaled foreign body in a child

Bould, M. Dylan

doi:10.1016/j.bjae.2019.01.005

Cited by 5 publications

(7 citation statements)

References 11 publications

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“…In his article on which he shared his personal experiences, Bould stated that in the sharing airline procedures they preferred to use intravenous agents in order to partially avoid the airline partnership and not be affected by the gas pollution of the operation team. 45 Although the surgical difficulty scale which includes bronchoscope size, localization of TBFB and features of TBFB in our study was similar in both groups, the surgeon comfort scale score was found to be lower with sevoflurane. The reason for this is the disturbing effect of sevoflurane gas coming directly from RB during bronchoscopy and the effects of spreading this gas into the room air.…”

Section: Discussioncontrasting

confidence: 45%

Çocuk Yaş Grubu Yabancı Cisim Aspirasyonu Tedavisinde Kullanılan Rijit Bronkoskopi Esnasında Uygulanan İki Anestezi Tekniğine Cerrahi Bir Bakış

SEZER,

ÇARDAKÖZÜ,

ELİCORA

2023

Acta Med Nicomedia

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Objective: In our study, we aimed to reveal the advantages and disadvantages of inhalation and intravenous anesthesia techniques in the maintenance of anesthesia in pediatric patients whose tracheobronchial foreign body was removed by rigid bronchoscopy under general anesthesia, from both anaesthesia and surgical perspectives, different from the literature. Methods: The patients were divided into two groups, each consisting of 34 individuals, whose anaesthesia was maintained with sevoflurane inhalation or propofol infusion. Demographic characteristics of the patients, symptoms at presentation, radiological examinations, anaesthesia and surgical procedures, complications were analyzed. In addition, surgical difficulty and surgical comfort scales created from the experiences of our institution were used. The results obtained and the effects of inhalation and intravenous anaesthetics used in maintenance on the duration of the procedure, clinical, hemodynamic and surgical comfort were compared. Results: Vital signs during the procedure were similar in both groups. was similar. The duration of bronchoscopy was statistically significantly shorter in the intravenous anaesthesia group (p=0.014), and secondarily, the duration of anaesthesia was significantly longer in the inhalation anaesthesia group (p=0.027). While the surgical difficulty scale was similar in both groups, the surgical confort scale was significantly higher in the intravenous anesthesia group (p=0.017). Intraoperative, postoperative complications were similar in both groups. Conclusion: Anaesthesia maintenance with sevoflurane prolongs the duration of bronchoscopy and accordingly the duration of anaesthesia, and also reduces surgical satisfaction independent of processing time. For these reasons, we think that while rigid bronchoscopy is performed for the removal of childhood foreign body aspirations, propofol can be preferred for anaesthesia maintenance, resulting in a shorter procedure time and higher surgical satisfaction.

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Section: Discussioncontrasting

confidence: 45%

Çocuk Yaş Grubu Yabancı Cisim Aspirasyonu Tedavisinde Kullanılan Rijit Bronkoskopi Esnasında Uygulanan İki Anestezi Tekniğine Cerrahi Bir Bakış

SEZER,

ÇARDAKÖZÜ,

ELİCORA

2023

Acta Med Nicomedia

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“…Intrahospital preoperative assessment in children with aspirated foreign body implies ensuring oxygenation and minimizing anxiety in children by trying to develop a rapport with the patient; parental presence; taking AMPLE history ( A llergies, M edications, P ast medical/anesthesia history, L ast meal, E vents leading up to the presentation); and asking about family history of problems with anesthesia ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Foreign Body Aspiration and Ingestion in Children

Karišik

2023

ACC

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SUMMARY Aspiration and ingestion of a foreign body is most frequently seen in children younger than 3 years. Foreign body aspiration is always a life-threatening, urgent state demanding quick recognition and treatment to avoid potentially lethal complications. Most foreign bodies that are ingested pass spontaneously through the gastrointestinal tract without complications, however, some could lead to problems if they become lodged. A literature review was performed via MEDLINE database using key terms. Primary care providers should be trained to give proper initial care. Aspirated/ingested foreign bodies in children removed by rigid or flexible bronchoscopy/gastroscopy always are challenging procedures that require well-planned anesthesia management and excellent intercommunication between anesthesiologists and surgeons. Extracorporeal membrane oxygenation can be used as a rescue mode of support in children with life-threatening foreign body aspiration for stabilization before, during and after removal of the aspirated foreign body. It is of utmost importance that all foreign body extractions, if possible, be done in centers supplied with all the necessary equipment and trained personnel. However, prevention of foreign body aspiration and ingestion is still the best therapy.

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“…Airway and ventilation management in the presence of TEF is challenging and spontaneous ventilation should be maintained whenever possible [ 8 , 9 ]. In this case, we chose general anesthesia with rapid sequence induction and orotracheal intubation, regarding the risk of aspiration and respiratory distress.…”

Section: Discussionmentioning

confidence: 99%

Unexpected Presentation of Tracheoesophageal Fistula During Intubation in a Pediatric Patient

Telo,

Morais,

Ferreira

et al. 2023

Cureus

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Tracheoesophageal fistula (TEF) is an abnormal connection between the trachea and esophagus. This report presents a rare case of a pediatric patient who developed a TEF due to battery ingestion, which was diagnosed during intubation and resulted in cardiac arrest. A 4-year-old child with a two-year history of battery ingestion presented with severe dehydration, weight loss, and recurrent respiratory tract infections. Chest X-ray revealed a radiopaque foreign body in the esophagus. During general anesthesia for central venous line insertion and after endotracheal intubation, some difficulties in ventilation occurred, characterized by the inability to reach tidal volume, absence of capnography, and stomach distention which led to hypoxia and ultimately to cardiac arrest. Prompt resuscitation (CPR) was initiated, and selective right bronchial intubation during CPR improved the patient's condition. Subsequent bronchofibroscopy performed in the ICU confirmed the TEF, which was surgically corrected during the hospital stay. TEF poses challenges in anesthesia and airway management, particularly when positive pressure ventilation is used. In this case, the TEF was diagnosed during intubation, highlighting the critical role of clinical expertise and prompt intervention in managing this unexpected pediatric critical event.

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Essential notes: the anaesthetic management of an inhaled foreign body in a child

Cited by 5 publications

References 11 publications

Çocuk Yaş Grubu Yabancı Cisim Aspirasyonu Tedavisinde Kullanılan Rijit Bronkoskopi Esnasında Uygulanan İki Anestezi Tekniğine Cerrahi Bir Bakış

Çocuk Yaş Grubu Yabancı Cisim Aspirasyonu Tedavisinde Kullanılan Rijit Bronkoskopi Esnasında Uygulanan İki Anestezi Tekniğine Cerrahi Bir Bakış

Foreign Body Aspiration and Ingestion in Children

Unexpected Presentation of Tracheoesophageal Fistula During Intubation in a Pediatric Patient

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