Flexible bronchoscopy: the first-choice method of removing foreign bodies from the airways of children

Lima, Evelise; Espindula, Bianca Fidelix; Morais, Isadora Oliveira; Scordamaglio, Paulo Rogério; Cukier, Alberto

doi:10.36416/1806-3756/e20210387

Cited by 1 publication

(3 citation statements)

References 11 publications

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“…With the advancements in technology and therapeutic techniques, flexible bronchoscopy has become increasingly utilized to remove FBs in patients of different age groups. (1)(2)(3)(7)(8)(9)14,16) However, this does not imply that rigid bronchoscopy should be disregarded; its use may be limited to specific cases where flexible bronchoscopy fails, appropriate equipment and accessories are lacking, or the bronchoscopist has extensive experience. (16) In our study, no fatal complications were encountered, and the most common adverse event was hypoxemia, which occurred in 5.1% of the procedures, predominantly in children.…”

Section: ❚ Resultsmentioning

confidence: 99%

“…( 1 ) Prior to manipulating the FB, a bronchial tree inspection was performed by instilling small aliquots of a diluted epinephrine solution (1:20,000 concentration, 1mL of adrenaline, and 19mL of isotonic sodium chloride solution). ( 1 , 2 , 9 , 14 , 15 ) This initial approach aimed to avoid fragmentation of the FB. In cases where the FB has been present for more than 4 weeks, removal may need to be performed in two stages, as previously described.…”

Section: Discussionmentioning

confidence: 99%

“…If the bronchial mucosa is highly inflamed and it is impossible to remove the FB, a second attempt can be made after 3–4 days, along with the use of systemic corticosteroids and antibiotics to control the inflammation and infection of the bronchial mucosa, which will facilitate subsequent manipulation. ( 1 , 9 , 14 , 16 ) In cases of long-term FBs associated with endobronchial scarring, removal can be performed after bronchial dilatation, as shown in figure 4 .…”

Section: Discussionmentioning

confidence: 99%

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Analysis of 108 flexible bronchoscopies for the removal of foreign bodies from the airways

Costa,

Palomino,

Suzuki

et al. 2023

Einstein (São Paulo)

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Objective To describe the clinical, bronchoscopic, diagnostic, and therapeutic aspects between children and adults. Methods This retrospective study compared the clinical and bronchoscopic characteristics of adults and children who underwent bronchoscopy for suspected foreign body aspiration. Data on sex, outpatient or emergency origin, bronchoscopy results, characteristics of the aspirated foreign body, and complications were analyzed. Results In total, 108 patients were included in the analysis, with foreign body aspiration diagnosed in 69% of patients (30 children and 44 adults). In 91% of patients, there was a clinical history suggestive of aspiration. The mean age of the adults was 65.89 (±19.75) years, and that of the children was 2.28 (±1.78) years. Most of the children were under 3 years of age (80%), while adults were mostly 70 years of age or older (54.5%). Emergency care was more common among children than adults. The most common foreign bodies found in both age groups were organic bodies, primarily seeds. The most frequent locations of foreign bodies were the lobar bronchi in adults and the main bronchi in children. Flexible bronchoscopy is the primary method for diagnosis and treatment. Transient hypoxemia occurred particularly frequently in children (5%). Conclusion Foreign body aspiration, particularly that involving seeds, is more common in the extremes of age. A clinical history suggestive of aspiration is crucial in determining the need for bronchoscopy, which should be performed as early as possible. Flexible bronchoscopy is an effective and safe diagnostic technique.

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