How we do it: management of tracheobronchial foreign bodies in children

Abstract

Foreign body aspiration remains an important pathology in children. Management of airway foreign bodies must be undertaken in specialized units with experienced staff and known protocols. Development and improvement of rigid bronchoscopes, with advances in anaesthesia have increased the efficacy and the safety of removing endotracheal foreign bodies. A video monitor is advantageous in coordinating the procedure and reducing the stress of the team. Utilization of Fogarty's catheters can be beneficial.

The risk of foreign body aspiration in children can be reduced with proper education of the general population

“…As a conclusion, foreign body aspiration continues to present a diagnostic challenge to primary care physicians [10,15]. Misdiagnosis and failure to act properly may have lethal consequences.…”

“…It should be mentioned that during the last few months, flexible bronchoscopy has been introduced by the Department of Pediatrics in our hospital as a diagnostic and therapeutic tool for foreign body aspiration in children. This procedure is expected to reduce the number of rigid bronchoscopies under general anaesthesia, especially with negative results, even further in the future [5,15].…”

Inhaled foreign bodies in pediatric patients: Review of personal experience

“…Although it is clear that the treatment of FB inhalation is achieved in the operating room or in an endoscopy unit under general anesthesia, and by rigid bronchoscopy [15,16], the choice of anesthesiological technique (spontaneous respiration or the administration of a muscle relaxant associated with controlled respiration) is still actively discussed [10,[17][18][19]. Herein, we report our experience on FB aspiration in pediatric patients, in particularly perioperative complications correlated to type of anesthesiological agent and duration of surgical procedure were analyzed.…”

Real-Time Video-Assisted Retrieval of Airway Foreign Body in Very Young Pediatric Patients

“…It provides adequate spaces for manipulation of instruments including grasping forceps and enhances ventilation safety during the procedure [15]. However, the conventional method that relies naked eye may have technical concerns such as blind manipulations of the grasping forceps [13,14]. One can easily imagine that the incorporation of an endoscope system could enhance the visualization and manipulation in the rigid bronchoscopy procedure compared with the use of naked eyes.…”

“…Conventionally, this technique involves the insertion of a rigid bronchoscope and naked eye manipulation. With the advancement of medical imaging and endoscope systems, the incorporation of an endoscope to the rigid bronchoscopy procedure has greatly improved the accuracy of diagnosis and manipulation with less morbidity [13,14]. Furthermore, combining optical forceps with endoscopy has enhanced one-hand manipulation under endoscopic guidance [14].…”