The characteristics of foreign bodies aspirated by children across different continents: A comparative review

Abstract

Background Foreign body aspiration (FBA) is a common issue in pediatric emergencies, with regional variations. Various cultures and foods, parents' and physicians' inadequate experience, and lack of bronchoscopy equipment are some attributable factors in the regional variation of FBA. Aim To more accurately represent the demographic characteristics of aspirated foreign bodies (FBs) across various continents, this review attempted to provide organized information based on the reviewed articles. Methodology A search was conducted in PubMed/PubMed Central, EMBASE, and google scholar. From the 36 included articles, information on age, gender, bronchoscopy type, type of FB, location, history of choking, and time elapsed between aspiration and admission were extracted. Results A total of 14,469 cases were evaluated. According to the findings, children under two accounted for more than 75% of FBAs. Nuts and seeds were the most common FBs in most countries, whereas plastic and metal objects had higher rates in Brazil, and calcified objects were more prevalent in Thailand. The right bronchus was the most frequent location, and rigid bronchoscopy was the most often utilized type of bronchoscope. In addition, a significant percentage of patients were referred to the emergency rooms in the first 12−24 h following the aspiration incident. Moreover, Asian patients reported more choking history, and Europeans had fewer witnesses of FBA. Conclusions There is a lack of standardized reporting systems and organized guidelines in pediatric FBA. To select the ideal time for endoscopies and create educational programs, a collaboration between experienced researchers, pediatric pulmonologists, radiologists, and otolaryngologists is required.

Artificial intelligence in the detection of non-biological materials

“…Globally, it is estimated that from 1990–2019, foreign body aspiration had an incidence of 109.6 per 100,000 children under five years old[ 61 ]. Like foreign body ingestion, the most commonly aspirated objects include batteries, coins, and other inorganic objects, though organic objects and food items are far more frequent causes [ 62 ].…”

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“…Similarly, they were responsible for approximately 0.6 deaths per 100 000 children aged zero to 4 years in the United States in 2020 [13 ▪▪ ]. Recently, a comparative review of the literature on the characteristics of FBA was published by Parvar et al [14 ▪▪ ]. It included 36 articles (30 retrospective studies and 6 prospective controlled clinical trials), and evaluated a total of 14,469 cases.…”

“…Nuts and seeds are the most common aspirated foreign bodies in most countries. This is why the incidence of FBA is significantly higher in countries where peanuts and seeds are traditionally eaten at an early age than in countries where these foods are introduced much later [14 ▪▪ ]. Interestingly, there were fewer cases of FBA during COVID-19 lockdown periods, compared to postlockdown periods, presumably due to better parental supervision [15 ▪ ].…”