Consumer product ingestion and aspiration in children: A 15‐year review

Hanba, Curtis; Cox, Steven R.; Bobian, Michael; Svider, Peter F.; Gonik, Nathan; Shkoukani, Mahdi A.; Sheyn, Anthony

doi:10.1002/lary.26216

Cited by 24 publications

(21 citation statements)

References 44 publications

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“…Generally, FB injuries involving the respiratory and digestive tract occur more often in young children (less than 4 years of age), while insertion of FBs is reported more frequently in pre‐schoolers. In this study, the majority of patients with FB ingestions were younger than 3 years of age and only approximately one‐third of patients were over 3 years old.…”

Section: Discussionmentioning

confidence: 99%

Injuries due to foreign body ingestion and insertion in children: 10 years of experience at a single institution

Shao

Shen

Hong

et al. 2019

J Paediatrics Child Health

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Aim: Foreign body (FB) injuries represent a severe public health problem during childhood. The aim of this study was to report our experience with patients with injuries due to FB ingestion and insertion who were treated surgically at our institution. Methods: A total of 78 paediatric patients who were hospitalised for FB injuries were retrospectively reviewed. Results: The series was composed of 27 males and 51 females, with a median age of 3.6 years. The cases included 35 cases of FB ingestion and 43 cases of FB insertion, including 40 cases with a vaginal insertion, 2 cases with a rectal insertion and 1 case with a urethra insertion. Intestinal perforation (n = 26) was a more common complication than intestinal obstruction (n = 9) in patients who had ingested a FB. The main clinical symptom was persistent vaginal discharge, followed by vaginal bleeding for patients with a vaginal FB insertion. Exploratory laparotomy was performed on 36 patients, while a laparoscopic approach was employed in 1 patient. Forty patients underwent hysteroscopy and one patient underwent cystotomy to remove the FB. All FBs were successfully removed. Of the 78 FBs recovered, 26 were food objects, while non-food objects were found in 52 patients. All patients recovered well, except one patient with an intestinal obstruction from adhesions that occurred approximately 1 month after discharge. Conclusions: Early recognition of FB injuries and appropriate management can significantly reduce complications. Surgical removal of a FB can be safe and effective, and relatively better outcomes can be achieved.What is already known on this topic 1 Foreign body (FB) injuries represent a severe public health problem during childhood. 2 Some FB injuries have an unclear history and non-specific clinical presentation, resulting in a delay in diagnosis.

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Section: Discussionmentioning

confidence: 99%

Injuries due to foreign body ingestion and insertion in children: 10 years of experience at a single institution

Shao

Shen

Hong

et al. 2019

J Paediatrics Child Health

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“…[2] Studies have linked this complication to postoperative coughing and lower airway disease. [12] The aim of this randomized controlled trial was to study the effect on emergence of placing a LMA before removal of the ETT in the minimally invasive endoscopic endonasal transsphenoidal pituitary surgery. To that end, we compared systemic and cerebral hemodynamic variables and cough incidence during emergence from general anesthesia under two conditions: after ETT extubation, according to standard procedure or after replacement of the ETT with a LMA just before extubation.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic response, coughing and the incidence of cerebrospinal fluid leakage on awakening with an endotracheal tube or laryngeal mask airway in place after transsphenoidal pituitary surgery: a randomized clinical trial

Hurtado

Tercero

García-Orellana

et al. 2021

Preprint

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Background: We aimed to compare systemic and cerebral hemodynamic variables and cough incidence during emergence from general anesthesia after pituitary surgery in patients after extubation of an endotracheal tube (ETT) or after replacing the ETT with a laryngeal mask airway (LMA). Methods: Patients undergoing pituitary surgery were randomized (open-label parallel trial) to awaken with the ETT in place or after it had been replaced with a LMA before extubation. We recorded mean arterial pressure (MAP), heart rate, middle cerebral artery (MCA) flow velocity, regional cerebral oxygen saturation (SrO2), cardiac index, norepinephrine plasma concentrations, need for vasoactive drugs, coughing during emergence, and incidence of postoperative cerebrospinal fluid (CSF) leakage. Results: Forty-five patients were included. MAP was lower during emergence than at baseline in both groups. More patients required antihypertensive drugs in the ETT group (34.8% vs 14.3%; P = 0.17). MCA flow velocity was higher in the ETT group (e.g., mean [95% confidence interval] at 15 min, 103.2 [96.3–110.1] vs 89.6 [82.6–96.5] cm s− 1; P = 0.003). SrO2, cardiac index, and norepinephrine plasma levels were similar. Coughing was more frequent in the ETT group (15% vs 81%; P < 0.001). CSF leakage occurred in 3 patients (13%) in the ETT group only. Conclusions: Placing a LMA before removing an ETT during emergence from anesthesia after pituitary surgery favors a safer cerebral hemodynamic profile and reduced coughing. This strategy may also lower the risk for CSF leakage. Trial registration number: NCT02988804 (clinicaltrials.org) (09/12/2016).

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“…FB in the airway can lead to choking and ultimately death due to asphyxia if the diagnosis is delayed [4]. National Safety Council of America in 2016 proposed the rate of fatal choking in children < 5 years of age in the American general population was 0.43 per 100,000 [5].…”

Section: Introductionmentioning

confidence: 99%

Clinical variables responsible for early and late diagnosis of foreign body aspiration in pediatrics age group

Goyal

Jain

Rai

et al. 2020

J Cardiothorac Surg

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Background Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention, it can lead to collapse, consolidation and pneumonia of the affected lung. Methods We retrospectively analyzed 37 pediatric case records who presented from January 2014–December 2018 with foreign body aspiration. Our primary aim was to assess the parameters responsible for early and late diagnosis of foreign body aspiration. We concluded with a diagnostic algorithm for management of foreign body aspiration on the basis of this outcome. Results Around 32.5% came with a history of aspiration, 43% were referred from the primary centers with a suspicion for the same and the rest came to our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea. Furthermore, those who came in after a week had a dry cough and fever as their main complaint. Majority of ingested foreign bodies was a vegetative type (80%) as compared to the non –vegetative. Conclusion Unlike adults, foreign body aspiration in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in the majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication.

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Consumer product ingestion and aspiration in children: A 15‐year review

Abstract: 4. Laryngoscope, 127:1202-1207, 2017.

Cited by 24 publications

References 44 publications

Injuries due to foreign body ingestion and insertion in children: 10 years of experience at a single institution

Injuries due to foreign body ingestion and insertion in children: 10 years of experience at a single institution

Hemodynamic response, coughing and the incidence of cerebrospinal fluid leakage on awakening with an endotracheal tube or laryngeal mask airway in place after transsphenoidal pituitary surgery: a randomized clinical trial

Clinical variables responsible for early and late diagnosis of foreign body aspiration in pediatrics age group

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