Risk factors associated with hypoxemia during foreign body removal from airways in childhood

Bittencourt, Paulo Fernando Souto; Camargos, Paulo Augusto Moreira; Picinin, Isabela Furtado de Mendonça

doi:10.1016/j.ijporl.2013.03.026

Cited by 9 publications

(8 citation statements)

References 20 publications

(48 reference statements)

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“…A previous study reported that bronchoscopy under sedation provides comfort to the patient and bronchoscopist 28 , while other studies evaluated drugs that are more effective for sedation during the procedure 29,30 . However, few studies have analyzed the risk factors for hypoxia during bronchoscopy under sedation in adults 15,31 , although some have analyzed these risk factors for pediatric patients undergoing foreign body removal via bronchoscopy 16,17 . Determination of these risk factors for adult patients is important because of the widespread use of bronchoscopy, including interventional bronchoscopy 7 , and the increase in the number of elderly patients undergoing the procedure 32 .…”

Section: Discussionmentioning

confidence: 99%

“…Finally, Chen et al 17 reported that the longer duration of surgical procedure (>20 minutes) was correlated with intraoperative hypoxemia in young patients undergoing rigid bronchoscopy. And, Bittencourt et al 16 had also resulted that a longer procedure time was vulnerable to a risk of hypoxemia in children. In our study result, we found that a longer duration of sedation (>40 minutes) was a significant risk factor for hypoxia.…”

Section: Discussionmentioning

confidence: 99%

“…It is generally transient and resolves instantly; however, the clinician should consider terminating the procedure in cases where hypoxia persists for >1 minute 1 . Several studies have reported the risk factors associated with hypoxia during bronchoscopy for foreign body removal in children 16,17 . The findings of those studies indicated that the patient' s age and procedure duration were associated with the occurrence of hypoxia during bronchoscopy 16,17 .…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported the risk factors associated with hypoxia during bronchoscopy for foreign body removal in children 16,17 . The findings of those studies indicated that the patient' s age and procedure duration were associated with the occurrence of hypoxia during bronchoscopy 16,17 . However, few studies have reported the risk factors for predicting hypoxia in elderly patients undergoing bronchoscopy under sedation.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

Choi

Lee

et al. 2020

Tuberc Respir Dis

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Background: Flexible bronchoscopy is one of the essential procedures for the diagnosis and treatment of pulmonary diseases. The purpose of this study was to identify the risk factors associated with the occurrence of hypoxia in adults undergoing flexible bronchoscopy under sedation. Methods: We retrospectively analyzed 2,520 patients who underwent flexible bronchoscopy under sedation at our tertiary care university hospital in South Korea January 1, 2013-December 31, 2014. Hypoxia was defined as more than 5%-point reduction in the baseline percutaneous oxygen saturation (SpO 2) or SpO 2 <90% for >1 minute during the procedure. Results: The mean age was 64.7±13.5, and 565 patients developed hypoxia during the procedure. The mean sedation duration and midazolam dose for sedation were 31.1 minutes and 3.9 mg, respectively. The bivariate analysis showed that older age, a low forced expiratory volume in one second (FEV 1), use of endobronchial ultrasound, the duration of sedation, and the midazolam dose were associated with the occurrence of hypoxia during the procedure, while the multivariate analysis found that age >60 (odds ratio [OR], 1.32), a low FEV 1 (OR, 0.99), and a longer duration of sedation (>40 minutes; OR, 1.33) were significant risk factors. Conclusion: The findings suggest that patients older than age 60 and those with a low FEV 1 tend to develop hypoxia during the bronchoscopy under sedation. Also, longer duration of sedation (>40 minutes) was a significant risk factor for hypoxia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

Choi

Lee

et al. 2020

Tuberc Respir Dis

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“…Harboyen and Nassif [21] reported 36 instances (16%) of tracheostomy in 225 bronchoscopies, mostly in the prolonged traumatic procedures. Bittencourt et al [22] analysed the variables associated with hypoxaemia in children who underwent rigid bronchoscopy for foreign body removal. Among the patients aged up to one year the risk of hypoxaemia was five and half times higher than for patients aged one year or older (OR = 5.6).…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Prognosis in the Endoscopic Extraction of Foreign Bodies in Kashmiri Population

Sheikh¹,

Afshan²,

Sheikh³

et al. 2019

IJOHNS

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An updated approach in the management of 50 patients with foreign body inhalation is presented. Certain risk factors that lead to complications and mortality due to endoscopic extraction of foreign bodies and thus determine prognosis were identified. Remedial measures to reduce morbidity and mortality due to bronchoscopic removal of foreign bodies are suggested. Fifty patients of suspected foreign body inhalation presented to a Unit of the Department of ENT, Head and Neck Surgery of Government Medical College associated SMHS Hospital Srinagar, Kashmir from March 2007 to June 2017. Of these, 49 patients were subjected to rigid tube bronchoscopy for removal of the aspirated foreign bodies and one coughed out the foreign body spontaneously during admission for bronchoscopy. History of foreign body inhalation was positive in 90% of patients and remaining was mostly referred from Paediatric Units with un-resolving collapse-consolidation of the lung. Whereas plain radiography of the chest and the soft tissues of neck were the primary imaging modality used in this study to detect the inhaled foreign bodies or their effects there are reports of virtual bronchoscopy being done with a multidetector computed tomography scanner in 3D image generation from axial cuts of the internal walls of the tracheobronchial tree in the management of patients suspected with foreign body aspiration. Bronchoscopy is a difficult and potentially hazardous procedure in the infant and young child. Telescopes and telescopic forceps were used during bronchoscopy to facilitate extraction of a foreign body inhaled. The type of a foreign body, site of its enlodgement and the complications encountered during its extraction were noted. During bronchoscopy the patients were connected to an ECG monitor How to cite this paper: Sheikh, M.S.,

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The characteristics of foreign bodies aspirated by children across different continents: A comparative review

Parvar

Sarasyabi

Moslehi

et al. 2022

Pediatric Pulmonology

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Background Foreign body aspiration (FBA) is a common issue in pediatric emergencies, with regional variations. Various cultures and foods, parents' and physicians' inadequate experience, and lack of bronchoscopy equipment are some attributable factors in the regional variation of FBA. Aim To more accurately represent the demographic characteristics of aspirated foreign bodies (FBs) across various continents, this review attempted to provide organized information based on the reviewed articles. Methodology A search was conducted in PubMed/PubMed Central, EMBASE, and google scholar. From the 36 included articles, information on age, gender, bronchoscopy type, type of FB, location, history of choking, and time elapsed between aspiration and admission were extracted. Results A total of 14,469 cases were evaluated. According to the findings, children under two accounted for more than 75% of FBAs. Nuts and seeds were the most common FBs in most countries, whereas plastic and metal objects had higher rates in Brazil, and calcified objects were more prevalent in Thailand. The right bronchus was the most frequent location, and rigid bronchoscopy was the most often utilized type of bronchoscope. In addition, a significant percentage of patients were referred to the emergency rooms in the first 12−24 h following the aspiration incident. Moreover, Asian patients reported more choking history, and Europeans had fewer witnesses of FBA. Conclusions There is a lack of standardized reporting systems and organized guidelines in pediatric FBA. To select the ideal time for endoscopies and create educational programs, a collaboration between experienced researchers, pediatric pulmonologists, radiologists, and otolaryngologists is required.

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Risk factors associated with hypoxemia during foreign body removal from airways in childhood

Cited by 9 publications

References 20 publications

Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

Factors Influencing Prognosis in the Endoscopic Extraction of Foreign Bodies in Kashmiri Population

The characteristics of foreign bodies aspirated by children across different continents: A comparative review

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