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[Inhalation of foreign bodies]
A Pigna1, V Bachiocco, R De Rose
1Servizio di Anestesia e Rianimazione, Policlinico S. Orsola-Malpighi, Bologna. picu@orsola-malpighi.med.unibo.it
Insights
Foreign body aspiration in children is a common, life-threatening home accident. Early diagnosis and intervention, even with unclear symptoms, are crucial for preventing severe complications.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Tract Foreign Bodies
- Accidental Injury Prevention
Context:
- Foreign body aspiration (FB) is a frequent and dramatic event in children, a leading cause of accidental death in those under four.
- Clinical presentation varies widely, from severe asphyxia to insidious symptoms, often leading to delayed diagnosis.
Purpose:
- To review the diagnostic and therapeutic challenges of foreign body aspiration in children.
- To highlight the importance of prompt endoscopic evaluation in suspected cases, regardless of clinical or radiological findings.
Summary:
- A review of 62 pediatric patients with suspected foreign body aspiration over 11 years.
- Organic materials, primarily peanuts, were the most common aspirated foreign bodies in children aged 0-3 years.
- Inorganic materials were more prevalent in older children. Post-extraction complications were managed with antibiotics, dexamethasone, and CPAP support.
Impact:
- Emphasizes the critical need for heightened awareness and educational campaigns for prevention.
- Underscores that prompt diagnostic and operative endoscopic examinations are vital, even with negative initial assessments.
- Highlights the role of medical interventions in mitigating post-procedural sequelae.
Abstract:
Accidental aspiration of a foreign body (FB) is an event which is reasonably frequent and dramatic in children and is still today one of the main causes of death due to accidents at home in children up to three-four years of age. The severity of the clinical picture varies according to the size, shape, type and site of arrest of the material aspirated and can be associated with both severe asphyxial forms and forms with insidious and vague symptoms which are difficult to diagnose correctly. A late diagnosis is however a fairly common event in literature. An anamnesis suggesting probable aspiration in a child under the age of 3 should direct doctors towards diagnostic and operative endoscope examinations of the patient, even where there is a negative clinical and radiological picture. Organic material, mainly peanuts, represented 60-75% of the findings, particularly in the 0-3 year age-band. In the other of cases inorganic material was extracted from school-age children. Aspiration of a FB exposes the patient to risk of serious complications and sequelae. Antibiotic, dexamethasone therapy and the ventilation support in the CPAP helped to avoid post-extractive sequelae. Prevention should in any case be the primary aim as regards to aspiration of foreign bodies in children. This should be stimulated by appropriate educational campaigns to raise awareness. The study included 62 child patients observed in the Department of Anesthesia and Intensive Care of the S.Orsola-Malpighi Hospital of Bologna over the last 11 years who were admitted for suspected FB aspiration.