Removal of distal airway foreign body with the help of fluoroscopy in a child

Goussard, Pierre; Mfingwana, Lunga; Morrison, Julie

doi:10.1002/ppul.24653

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…Fluoroscopy provides real time images and is rarely used for FB evaluation (29). It has been used intraprocedurally to guide forceps especially, when the FB gets lodged distally (30)(31)(32). ) that was inadvertently introduced via "Murphy eye" of a size 8.0 endotracheal tube.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Foreign body aspiration

Bajaj¹,

Sachdeva²,

Deepak³

2021

J Thorac Dis

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The clinical manifestations of foreign body (FB) aspiration can range from an asymptomatic presentation to a life-threatening emergency. Patients may present with acute onset cough, chest pain, breathlessness or sub-acutely with unexplained hemoptysis, non-resolving pneumonia and at times, as an incidental finding on imaging. Patients with iatrogenic FB such as an aspirated broken tooth during difficult intubation or a broken instrument are more common scenarios in the intensive care unit (ICU).Patients with post-obstructive pneumonia with or without sepsis, or variable degree of hemoptysis often require ICU level of care and bronchoscopic interventions. Rigid bronchoscopy has traditionally been the modality of choice; however, with the innovation in instrumentation and wider availability of flexible bronchoscopes, most of the FB removal is now successfully performed using flexible bronchoscopy.Proceduralists choose instruments in accordance with their training and expertise. We describe the use of most common instruments including forceps, balloon catheters, and baskets. Role of cryoprobe and LASER in FB removal is reviewed as well. In general, larger working channel bronchoscopes are preferred; however, smaller working channel bronchoscopes may be used in situations when the patients are intubated with a smaller diameter endotracheal or tracheostomy tubes. Large size FB are removed en bloc with the grasping tool, bronchoscope, and endotracheal or tracheostomy tube, requiring preparation to safely re-establish the airway. After FB removal, bronchoscopy is re-performed to identify any residual FB, assess any injury to the airway, suction post-obstructive secretions or pus, control any active bleeding and remove granulation tissue that may be obstructing the airway. Additional interventions like balloon dilatation may be required to dislodge an impacted FB or to maintain patency of bronchial lumen. If bronchoscopic methods fail, surgery may be required for retrieval of FB in symptomatic patients or to resect suppurative or necrotizing lung process. Multidisciplinary approach involving intensivists, surgeons, and anesthesiologists is the key to optimal patient outcomes.

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Section: Diagnostic Evaluationmentioning

confidence: 99%

Foreign body aspiration

Bajaj¹,

Sachdeva²,

Deepak³

2021

J Thorac Dis

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“…Airway foreign body is a very common respiratory disease in life, which can occur at all ages, especially in children and the elderly. Inhalation of foreign bodies can cause chronic irreversible bronchopulmonary injury, which can seriously lead to sudden cardiac arrest, asphyxia, and even death [ 1 – 6 ]. Among the foreign bodies inhaled, peanuts, soybeans, cashew nuts, and other plant-based foreign bodies accounted for a high proportion.…”

Section: Introductionmentioning

confidence: 99%

Investigation and Analysis of the Influence of Vegetative Tracheobronchial Foreign Body on Airflow Field

Bao

2022

Applied Bionics and Biomechanics

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The BSL k-ω turbulence model was used to numerically simulate the inspiratory airflow of the airway with foreign bodies using a real CT scan human airway model. The paper selects three foreign bodies with different diameters, three different foreign body positions, and three different breathing intensities, and the FLUENT software is used to perform numerical simulation. This study has found that the increase in the diameter of the foreign body and flow velocity will make the flow structure in the airway more complicated. The airway pressure will increase so that the resistance of breathing will increase, and the shear force will also increase, which hurt the airway. The impact of the foreign body on the left side on the flow structure in the airway is less than that of the foreign body on the right side. The foreign body on the left side causes the pressure drop in the airway to be higher than that on the right side. Moreover, sharp changes in pressure driving force and airway curvature will affect the airflow pattern of the central airway. We concluded that foreign matter has a great influence on the characteristics of the airflow structure, and more research is needed to increase the understanding of the airflow pattern under the condition of foreign matter in the airway, and the research helps doctors avoid the influence of airflow when removing foreign bodies in the airway.

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“…Inhaled foreign bodies (AFBs) occur frequently in children [1][2] 。 When the AFB becomes firmly lodged in a child's tracheal carina, asphyxiation, a life-threatening emergent situation, may result in death, especially in children less than 1 year of age.…”

Section: Introductionmentioning

confidence: 99%