Pediatric Rigid Bronchoscopy for Tracheobronchial Foreign Bodies in Covid Times: Short Personal Experience

Abstract

This case series of 5 patients of rigid bronchoscopy done for tracheobronchial foreign bodies is presented to readers to share my experience of doing rigid bronchoscopy during Covid Times from March to July 2020 specifically sharing experience on personal protection with local innovations during the procedure. Indications, intra-procedure modifications and other relevant things are also presented. The observations and experience are purely personal gained during these months and may be subjected to further research and in no way substitute the well established facts.

Therapeutic and Interventional Bronchoscopy Performed in Critically ill COVID-19 patients: A Systematic Review

“…Bronchoscopy was successfully performed in 2 positive patients for mucus secretions aspiration and FBA removal (52). Foreign body aspiration was done only in few patients with COVID-19, mostly FBA was done once the RT-PCR test turned negative [53]. The presence of haematic secretions in the distal bronchial tract was found to the reason of high mortality in patients (50).…”

“…Post-partum COVID-19 related complications exacerbates, severity in these women are rare during pregnancy and therapeutic bronchoscopy could be performed successfully post-delivery [45-46, 58-59]. In infants or pediatric patients bronchoscopy proved to be a safe therapeutic device used for mucus plug removal [40, 52-53, 60]. In elderly patients with COVID-19 requiring lung transplant underwent routine therapeutic bronchoscopy no complications seen in patients caused by its regular usage (19-20).…”

“…These infections were not transmitted from patients in ICU wards as there was no outbreak of viral infections observed among other HCW present associated with the same bronchoscopic procedures [52]. Thereby, suggesting that the procedure is safe for the bronchoscopists, as maximum precautionary measures were adapted to reduce the aerosolization process [26, 52-53, 55, 59, 89].…”

Bronchoscopy for removal of foreign body: What's the big deal?

“…There are no pediatric published guidelines for management of a COVID-19 positive patient requiring bronchoscopy. 11,13 Published literature includes a single case report of rigid bronchoscopy in a suspected COVID-19 positive patient, 14 a five case report series that delayed FFB until the patient's COVID-19 status turned negative, 15 and a third study of four patients in which patient's converted to a positive COVID-19 test after the procedure. 16 The majority of information on handling COVID cases comes from adult publications early in the pandemic, with no pediatric specific guidance.…”