Retrieving difficult aspirated pen caps by balloon catheter with short working-length flexible endoscopy and noninvasive ventilation support in intensive care unit☆,☆☆

Soong, Wen‐Jue; Tsao, Pei Chen; Lee, Yu Sheng; Yang, Chia Feng; Liao, Jessica; Jeng, Mei Jy

doi:10.1016/j.ijporl.2015.06.033

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…Thirty-five (46.1%) intubations were performed in unordinary indications. These included 20 TFAE which guided the correct positioning of the end and/or the side holes of the endotracheal tube to prevent lumen blockade or injury to existing tracheal lesions during dynamic breathing movements [ 16 ]. Eight selective bronchial intubations were conducted to achieve one-lung ventilation to manage 5 cases of pulmonary bleeding, 2 persistent bronchopleural fistulas and 1 child with huge lobar pneumatocele.…”

Section: Resultsmentioning

confidence: 99%

Therapeutic flexible airway endoscopy of small children in a tertiary referral center—11 years’ experience

et al. 2017

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ObjectivesUse of therapeutic flexible airway endoscopy (TFAE) is very limited in pediatrics. We report our clinical experiences and long term outcomes of TFAE in small children from a single tertiary referral center.MethodsThis is a retrospective cohort study. Small children with their body weight no more than 5.0 kg who had received TFAE between 2005 and 2015 were enrolled. Demographic information and outcomes were reviewed and analyzed from medical charts and TFAE videos.ResultsA total of 313 TFAE were performed in 225 children. The mean age was 3.50 ± 0.24 (0.01–19.2) months old; the mean body weight was 3.52 ± 0.65 (0.57–5.0) kg. A noninvasive ventilation technique, without mask or artificial airway, was applied to support all the procedures. TFAE included laser therapy (39.6%), balloon dilatation plasty (25.6%), tracheal intubation (24.3%) and metallic stent placement (6.4%). Short-length endoscopes of 30–35 cm were used in 96%. All TFAE were successfully completed without serious adverse events or mortality. Mean procedural time was 27.6 ± 16.1 minutes. TFAE resulted in successful extubation immediately in 67.2% (45/67) and 62.8% (118/188) were able to wean off their positive pressure ventilation support in 7 days after procedures. By the end of this study, these TFAE averted the originally suggested airway surgeries in 93.8% (61/65), as benefited from laser therapy, stent implantation, and balloon dilatation plasty.ConclusionsThe TFAE modality of using short-length endoscopes as supported with this noninvasive ventilation and ICU support is a viable, instant and effective management in small children. It has resulted in rapid weaning of respiratory supports and averted more invasive rigid endoscopy or airway surgeries.

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Section: Resultsmentioning

confidence: 99%

Therapeutic flexible airway endoscopy of small children in a tertiary referral center—11 years’ experience

et al. 2017

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“…FBs similar to syringe cap have also been reported, but they all have a hole on one side and are successfully removed by balloon catheter technique. [4,5] Syringe cap is first reported as FB in this study with a positive history. In addition, 2 features of CT imaging, in this case, maybe helpful for the diagnosis:…”

Section: Discussionmentioning

confidence: 72%

Endobronchial foreign body removal using fiberoptic bronchoscope together with gastroscope biopsy forceps

Hao¹,

Tang

Ji³

et al. 2019

Medicine

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Rationale:There are many difficult cases in the clinic because of the diversity of foreign bodies. The removal of a syringe cap is not so easy because there is always no hole at the closed end.Patient concerns:A 54-year-old man suddenly developed dyspnea during his treatment in the hospital.Diagnoses:Foreign body in the left main bronchus.Interventions:The foreign body was removed using fiberoptic bronchoscope together with gastroscope biopsy forceps.Outcomes:A repeat CT showed well inflation of left lung.Lessons:The combined use of gastroscope biopsy forceps in trachea is more conducive to remove a foreign body similar to a syringe cap.

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“…There may be other advantages due to its safe, timely, and effective modality when resolving both lesions in this specific infantile population. Through our more than 20 years' clinical experience in the interventional FE in the pediatric airway, [9][10][11][12][13][14][15][16][17][18] familiar skill of this NP-NIV that can provide airway control, oxygenation, and ventilation has been the basic prerequisites to perform the perform pulmonary interventions using FE. Potential risks that may include significant hypoxia, hypoventilation, air-leak, and bleeding, although had not been happening in our practice.…”

Section: Discussionmentioning

confidence: 99%

“…FE, with a noninvasive ventilation (NIV) by continuous nasopharyngeal oxygen insufflation with optional nose‐close and abdomen compression (PhO 2 ‐NC‐AC and NP‐NIV) support, has already been used by our team for more than 20 years. This modality, FE with NP‐NIV, had also reported for feasibility, safety, and benefit in various difficult airway diagnostic and therapeutic interventions in pediatric patients 9‐19 . Continuous nasopharyngeal oxygen flow, assisted with optional nose‐close, can intentionally create positive pressure in the PLS.…”

Section: Introductionmentioning

confidence: 99%

“…This modality, FE with NP-NIV, had also reported for feasibility, safety, and benefit in various difficult airway diagnostic and therapeutic interventions in pediatric patients. [9][10][11][12][13][14][15][16][17][18][19] Continuous nasopharyngeal oxygen flow, assisted with optional nose-close, can intentionally create positive pressure in the PLS. While a maneuver of prolonged nose-close time results sustained pharyngeal inflation (SPI), [20][21][22][23][24] which indeed prolongs inspiration time, generates a peak plateau pressure and opens up the compromised PLS.…”

Section: Introductionmentioning

confidence: 99%

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Vallecular cyst with coexisting laryngomalacia: Successful diagnosis and laser therapy by flexible endoscopy with a novel noninvasive ventilation support in infants

Soong

Yang

Lee

et al. 2020

Pediatric Pulmonology

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Objective Vallecular cyst coexisting with laryngomalacia (VC‐LM) can cause significant pharyngolaryngeal obstruction. Traditionally, it is diagnosed with flexible endoscopy (FE) and treated by rigid endoscopy. This study evaluates the effectiveness of solely using FE with novel noninvasive ventilation (NIV) of sustained pharyngeal inflation (SPI) support for both diagnosis and treatment in such infants. Methods A retrospective review of consecutive infants who were diagnosed and treated for VC‐LM in the 12‐year period, 2007 to 2018, was conducted. Clinical variables, techniques, and outcomes were analyzed and reported. Results Eighteen infants (10 males) were included. The mean age was 3.0 ± 0.6 months and the mean body weight was 4.6 ± 1.3 kg. Before FE, 14 infants were supported with bi‐nasal prongs NIV (BN‐NIV) and four infants with tracheal intubation. During diagnostic and therapeutic FE, all infants supported with a nasopharyngeal NIV (NP‐NIV) only. All diagnoses were made in the first FE inspection of 3.5 ± 1.2 minutes. Thirteen lesions were immediately treated with FE laser therapy in 18.1 ± 1.7 minutes in the same FE course. Total FE time was 24.6 ± 2.8 minutes. Three infants needed revision laser therapy 4 days later. There was no desaturation (<90%), bradycardia (<100/min), or pneumothorax. After FE therapy, all infants were supported with BN‐NIV only with significantly (<0.01) lower pressure and completely weaned off before being discharged 8.4 ± 1.5 days later. All infants, followed up for a 6‐month period, showed many clinical improvements. Conclusions FE, with this NP‐NIV and SPI supports, could offer accurate diagnosis and successful laser therapy of the VC‐LM with procedural sedation in the same session in infants.

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Retrieving difficult aspirated pen caps by balloon catheter with short working-length flexible endoscopy and noninvasive ventilation support in intensive care unit☆,☆☆

Cited by 10 publications

References 18 publications

Therapeutic flexible airway endoscopy of small children in a tertiary referral center—11 years’ experience

Therapeutic flexible airway endoscopy of small children in a tertiary referral center—11 years’ experience

Endobronchial foreign body removal using fiberoptic bronchoscope together with gastroscope biopsy forceps

Vallecular cyst with coexisting laryngomalacia: Successful diagnosis and laser therapy by flexible endoscopy with a novel noninvasive ventilation support in infants

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