Paediatric bronchoscopy

Roberts, Steve; Thornington, R

doi:10.1093/bjaceaccp/mki015

Cited by 29 publications

(42 citation statements)

References 8 publications

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“…With this approach, positive pressure ventilation can be applied to reverse of atelectasis, to correct oxygenation and to overcome the airway resistance. Some anaesthesiologists prefer spraying the epiglottis, larynx and the cords with 1% topical lidocaine before the procedure to reduce the haemodynamic and airway reactions to the introduction of the bronchoscope into the airways, reducing the need for general anaesthetic use and the risks of laryngospasm (11,24). Use of manual jet ventilation during bronchoscopy in nonobstructed lung prevents the hypoxaemia that can arise despite spontaneous or controlled ventilation.…”

Section: Anaesthetic Considerationsmentioning

confidence: 99%

“…If, on the other hand, a complication has arisen, or the procedure has been prolonged, or there is residual neuromuscular blockade, the patient is indicated for continued entubation and positive pressure ventilation for re-expansion of any atelectasis, and until completely awake and stabilised with adequate protective reflexes (24).…”

Section: Anaesthetic Considerationsmentioning

confidence: 99%

“…Pneumonia, atelectasis and emphysema are the most frequently observed complications, but laryngeal oedema, complete airway obstruction secondary to dislodged foreign body during coughing or removal, failure to remove the object, hypoxia, hypercarbia, bronchospasm, bradycardia, regurgitation and aspiration of gastric contents, pneumothorax, pneumomediastinum, lung abscess, tracheal laceration, cardiac dysrhythmias and cardiac arrest may also be observed (6,7,24). In delayed diagnosis cases bronchiectasis and irreversible pulmonary changes may develop (10,30).…”

Section: Complicationsmentioning

confidence: 99%

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The anaesthetic consideration of tracheobronchial foreign body aspiration in children

Kendigelen

2016

J. Thorac. Dis.

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Cases of tracheobronchial foreign body aspiration are frequently encountered emergency cases of childhood; and, delays in its recognition and treatment do result in serious morbidity and mortality.Diagnosis mainly relies on taking history which should indicate what the foreign body is, when it has been aspirated and where it is located. Belated consultation can cause misdiagnosis with the mixing of the symptoms and data with those of other pathologies common to childhood and further delays in the correct diagnosis. Bronchoscopy is required for the differential diagnosis of suspected tracheobronchial foreign body aspiration in order to eliminate other common pediatric respiratory concerns. Given the shared use of the airways by the surgeon and the anaesthesiologist, bronchoscopy is a challenging procedure requiring experienced teams with an efficient method of intercommunication, and also well planning of the anaesthesia and bronchoscopy ahead of the procedures. Despite the recent popularisation of the fiberoptic brochoscopes , the rigid bronchoscopy remains to be used commonly and is regarded to provide the gold standard technique. There have been reports in the literature on the uses of inhalation and/or intravenous (IV) anaesthesia and spontaneous or controlled ventilation methods without any demonstration of the superiority of one technique over the other. The most suitable methods of anaesthesia and ventilation would be those that reduce the risks of complications, morbidity and mortality; and, preventive measures should be taken with priority against childhood cases of tracheobronchial foreign body aspiration.

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Section: Anaesthetic Considerationsmentioning

confidence: 99%

Section: Anaesthetic Considerationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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The anaesthetic consideration of tracheobronchial foreign body aspiration in children

Kendigelen

2016

J. Thorac. Dis.

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“…Therefore, the patient should be assessed carefully and necessary treatments should be administered. While dexamethasone, humidified oxygen and nebulized racemic epinephrine are recommended to decrease stridor and stress after operation, it is emphasized that especially steroids should be used only if necessary (15).…”

Section: Discussionmentioning

confidence: 99%

Çocuk hastalarda yabancı cisim aspirasyonu nedeniyle uygulanan rijid bronkoskopi sonuçlarımız

...

2012

Tpa

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Aim: Tracheal or bronchial foreign body aspiration is a life-threatening emergency in children requiring immediate bronchoscopy under general anesthesia. The aim of this retrospective study was to evaluate the anesthetic management, hazards and complications of bronchoscopies performed because of suspicion of foreign body aspiration. Material and Method: We retrospectively analyzed the history, clinical and radiological findings and complications of 401 children admitted to the pediatric surgery department due to suspicion of foreign body aspiration between January 2006 and June 2011. Children requiring diagnostic bronchoscopies were excluded. All brochoscopies were performed under general anesthesia. Inhalation or IV induction and maintenance, spontaneous or controlled mechanical ventilation were selected individually according to the circumstances. Clinical findings, physical examination, radiological findings, anesthesia methods and complications of the patients were evaluated. Results: Cough (82%) and dyspnea (21.8%) were common symptoms of tracheobronchial foreign bodies. Most common radiological findings included air trapping (57%) and normal chest radiographs (21%). The aspirated foreign bodies were generally organic materials (80%) such as nuts, peanuts and seeds. The majority of foreign bodies lodged in the bronchial tree and the incidence of right sided (49.1%) foreign bodies was higher than that of the left sided (24.4%). Major complications during the anesthesia and postoperative period were desaturation, arrhythmia, hypercarbia and bronchospasm. Conclusions: Many problems can be experienced in children with inhaled foreign bodies. Bronchoscopy must be performed under optimal conditions in these patients. (Turk Arch Ped 2012; 47: 126-30)

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“…10 Flexible bronchoscopes, which have been in use since the 1960s, seem not to have been widely adopted in the neonatal anaesthesia field. [40][41][42] The smallest fibre-optic bronchoscope, with a diameter of 1.8 mm, could fit into a 2.5 mm ETT and be used to confirm positioning of the tube. The Olympus® BF N-20 and PF 27-M are two such ultrathin flexible bronchoscopes on the market.…”

Section: Preoperative Preparationmentioning

confidence: 99%

Anaesthesia for oesophageal atresia with or without tracheo-oesophageal atresia

Motshabi

2014

Southern African Journal of Anaesthesia and Analgesia

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Paediatric bronchoscopy

Cited by 29 publications

References 8 publications

The anaesthetic consideration of tracheobronchial foreign body aspiration in children

The anaesthetic consideration of tracheobronchial foreign body aspiration in children

Çocuk hastalarda yabancı cisim aspirasyonu nedeniyle uygulanan rijid bronkoskopi sonuçlarımız

Anaesthesia for oesophageal atresia with or without tracheo-oesophageal atresia

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