Removal of foreign bodies in children's airways using flexible bronchoscopic CO₂cryotherapy

Abstract

Removal of foreign bodies from children's airways using flexible bronchoscopic CO2 cryotherapy may be a safe, easy, and effective method. Pediatr Pulmonol. 2016; 51:943-949. © 2016 Wiley Periodicals, Inc.

ERS statement: interventional bronchoscopy in children

“…There is growing evidence that flexible bronchoscopes can be used as a removal tool (either alone or in combination with a rigid bronchoscope), using biopsy or grasping forceps, or wire baskets, with varying success rates [75][76][77][78]. Attempts to extract foreign bodies using a cryoprobe have been reported [79]; however, in children this technique has been associated with a high rate of complications [80]. If a flexible bronchoscope is used for foreign body extraction, immediate availability of a rigid instrument has been repeatedly recommended to guarantee safety of the procedure in case extraction attempts fail or complications occur [74,75].…”

Caution to use bronchoscopic CO2cryotherapy for foreign body removal in children

“…We share the opinion that the article published by Zhang et al calls for a strong note of caution . We would like to warn against introducing the potentially unsafe and dangerous technique of bronchoscopic cryoextraction of foreign bodies into clinical practice in children.…”

A toddler with a cough and wheeze refractory to treatment

“…Cryotherapy has multiple uses in adult pulmonology including removal of foreign bodies and transbronchial biopsy to diagnose granulomatous disease, infection, interstitial lung disease, lung cancer and post-transplant rejection. Its use in the paediatric population is more limited; however, Zhang et al 3 recently reported a series of 12 patients who had cryotherapy to remove a foreign body. In 2 of the 12 cases, cryotherapy damaged the airway mucosa causing asymptomatic partial obstruction of the airway.…”