Tracheotomy for Difficult Airway Foreign Bodies in Children

Samra, Sheena; Schroeder, James W.; Valika, Taher; Billings, Kathleen R.

doi:10.1177/0194599818758995

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…The result of this change is the rapid development of neurosurgery, and neurological severe disease has played a very important role in the development of neurosurgery. Neurocritically ill patients often use artificial airways because of their illness [ 2 ]. Generally speaking, patients who may use a ventilator for a long time will undergo tracheotomy.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Severe Respiratory Tract Infection and Prognosis in Neurosurgical Patients with Severe Tracheotomy Based on 5E Rehabilitation Nursing Model

Zhang

Wan

Chen

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. Continuous nursing based on 5E rehabilitation mode can improve the physiology and psychology of patients to some extent. The purpose of this study was to explore the effect of continuous nursing of 5E rehabilitation mode on the prevention and prognosis of severe respiratory tract infection in patients with severe tracheotomy in neurosurgery. Objective. To explore the effect of 5E rehabilitation nursing model on the prevention of severe respiratory tract infection and prognosis in patients with severe tracheotomy in neurosurgery. Methods. The starting and ending time of this study is from February 2019 to July 2021. In this paper, 60 patients with severe tracheotomy were divided into the control group and research group according to random number table method. The former group received routine nursing, and the latter group received rehabilitation nursing model based on 5E. The patients’ satisfaction, oxygenation index, partial pressure of carbon dioxide, partial pressure of oxygen, SAS, SDS score, incidence of severe respiratory tract infection, and quality of life scores were compared. Results. The nursing satisfaction of the research group was higher than that of the control group ( P < 0.05 ). 24 hours after weaning, the oxygenation index and partial pressure of oxygen in the research group were higher than those in the control group, while the partial pressure of carbon dioxide in the research group was lower than that in the control group ( P < 0.05 ). After nursing, the scores of self-rating anxiety scale and self-rating depression scale in the research group were lower than those in the control group, and the difference was statistically significant ( P < 0.05 ). The incidence of severe respiratory tract infection in the research group was significantly lower than that in the control group ( P < 0.05 ). After nursing, the scores of physiological function, psychological function, social function, and health self-cognition in the research group were lower than those in the control group ( P < 0.05 ). Conclusion. The nursing program of neurosurgical patients with severe tracheotomy based on 5E rehabilitation model can effectively enhance patients’ nursing satisfaction, activities of daily living, anxiety, and depression and promote the prognosis.

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Section: Introductionmentioning

confidence: 99%

Prevention of Severe Respiratory Tract Infection and Prognosis in Neurosurgical Patients with Severe Tracheotomy Based on 5E Rehabilitation Nursing Model

Zhang

Wan

Chen

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Jiaqiang S et al reported that pen cap inhalation was 2.65% of all cases, most frequently found in patients aged 6 to 14 years, and 76.4% of them were in the right main stem bronchus ( 13 ). Our result showed that most (86.7%) cases of pen aspiration occur in school age children (over 6 years old) because students are accustomed to placing pens in their mouth and then inhaling the objects when talking or laughing ( 14 ). 85.7% in cases of light-emitting diodes and 83.3% in cases of plastic parts of toys were accidents in preschool children due to their playful activity and propensity to bite toys.…”

Section: Discussionmentioning

confidence: 76%

“…Endoscopy showed that the vocal cords were in an adducted position in a 1-year-old child who spontaneously breathed under inhalation anesthesia ( 25 ). The object lodged below the vocal cords is dangerous and could cause dyspnea at any time, such as a board game piece or a pen cap ( 14 ). When an unusually shaped foreign body directly passes through the vocal folds and completely obstructs the respiratory tract, particularly in children, the patients undergo choking episodes and lie between life and death ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Management of Inedible Airway Foreign Bodies in Pediatric Rigid Bronchoscopy: Experience From a National Children's Regional Medical Center in China

et al. 2022

Front. Pediatr.

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The aim of this study is to analyze the characteristics of inedible airway foreign bodies in pediatric rigid bronchoscopy to facilitate the improvement of management and technology. This retrospective analytical study was performed from January 2017 to June 2020. All admissions of pediatric patients (age<18 years) with foreign-body aspiration diagnosis codes ([ICD]-10:T17 300, T17 400, T17 500 and T17 900) and procedure codes (33.7801) were extracted. Age, sex, preoperative history and imaging data, surgical records, length of hospital stay, reoperations and postoperative complications were included. Data were analyzed with SPSS 20. A total of 1237 patients were hospitalized and underwent rigid bronchoscopy. Forty-five (3.6%) patients with inedible foreign bodies in the airway were confirmed. There were no significant differences in sex, time of onset and length of hospital stay between the inedible and edible foreign body groups, except for age and a definite history of foreign body aspiration (P = 0.000). Coughing, wheezing and fever were the common clinical symptoms in all patients. The following were the common locations of inedible foreign bodies: right bronchus (22/45), left bronchus (18/45), trachea (3/45) and larynx (2/45). The most frequent inedible foreign bodies were parts of a pen (15/45), a light-emitting diode (7/45) and plastic parts of toys (6/45). Vocal cord injury and a laryngeal web were observed in one case each.ConclusionRigid bronchoscopy is the method of choice for the removal of inedible foreign bodies. Adequate preoperative assessment to rely on CT scans, skillful operation techniques to avoid damaging and active management of postoperative complications are important for the success of the procedure.

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“…Although flexible bronchoscopy can be considered as a valid option for FB retrieval, rigid bronchoscopy should be always available in the operative room and the surgical team should be qualified and ready to switch to any surgical option such as tracheostomy and/or bronchotomy [24].…”

Section: Discussionmentioning

confidence: 99%

Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of ﬂexible bronchoscopy and urology stone retrieval basket in emergency setting

2021

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Objective: Tracheobronchial aspiration of foreign body in children is an emergency that can lead to major complications. In the last years flexible bronchoscopy has gained popularity for foreign bodies retrieval in the pediatric population, yet the small size of the pediatric airway and of the flexible bronchoscope channel limit the availability of instruments during the procedure. Aim of this paper is to describe our experience in treating foreign bodies tracheobronchial aspiration in children aged 2 years or less by means of flexible bronchoscope and an urology stone retrieval basket. Methods: A review of endoscopic foreign bodies removal by means of flexible bronchoscopy and urology stone retrieval basket has been carried out in children ≤ 2 years that presented at the Emergency Room of our hospital from 2005 to 2019. In the paper, we analyze characteristics of patients, timing of bronchoscopy, instruments and operative management. Results: There were 25 patients with a mean age of 20 ± 3.8 months. Organic material was the most frequent observed foreign body. Association of main bronchus and distal bronchi was the preferred site of the foreign body in 19 patients and the right side of the bronchial tree was involved in 17 cases. Complications occurred in one case. Mean operation time was 37 ± 20 minutes. Conclusions: The use of flexible bronchoscope can be helpful in handling endoscopic removal of tracheobronchial foreign bodies in toddlers. The use of the urology stone retrieval basket resulted very effective in all shapes of foreign bodies and/or when the object was located in the distal bronchi.

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Tracheotomy for Difficult Airway Foreign Bodies in Children

Abstract: No sponsorships or competing interests have been disclosed for this article.

Cited by 5 publications

References 4 publications

Prevention of Severe Respiratory Tract Infection and Prognosis in Neurosurgical Patients with Severe Tracheotomy Based on 5E Rehabilitation Nursing Model

Prevention of Severe Respiratory Tract Infection and Prognosis in Neurosurgical Patients with Severe Tracheotomy Based on 5E Rehabilitation Nursing Model

Management of Inedible Airway Foreign Bodies in Pediatric Rigid Bronchoscopy: Experience From a National Children's Regional Medical Center in China

Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of ﬂexible bronchoscopy and urology stone retrieval basket in emergency setting

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