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Published on: January 17, 2011

Management of foreign bodies obstructing the airway in children

Rahul K Shah1, Anju Patel, Lina Lander

  • 1Children's National Medical Center, Washington, DC 20010, USA. rshah@cnmc.org

Archives of Otolaryngology--Head & Neck Surgery
|April 21, 2010
PubMed

Insights

Pediatric airway and esophageal foreign bodies are infrequent but potentially lethal. Most cases are treated at teaching hospitals, with a surprisingly high mortality rate, highlighting the need for better physician training.

Area of Science:

  • Pediatric Medicine
  • Emergency Medicine
  • Public Health

Background:

  • Airway foreign bodies (A-FBs) and esophageal foreign bodies (E-FBs) are significant causes of pediatric morbidity and mortality.
  • Effective management strategies are crucial for improving patient outcomes.

Purpose of the Study:

  • To analyze national trends in the management of pediatric patients with airway and esophageal foreign bodies causing airway obstruction.
  • To identify demographic, treatment, and outcome patterns associated with these conditions.

Main Methods:

  • Retrospective analysis of the Kids' Inpatient Database 2003, a national pediatric discharge dataset.
  • Inclusion of patients aged 20 years or younger with International Classification of Diseases, Ninth Revision, Clinical Modification codes E911 and E912.
  • Weighted data were used to generate national estimates of A-FB and E-FB admissions.

Main Results:

  • 2771 pediatric patients were admitted for airway-obstructing A-FBs or E-FBs; 55% were under 2 years old.
  • Food was the most common foreign body type (42%). Average length of stay was 6.4 days, with 71% treated at teaching hospitals.
  • Mortality rate was 3.4%, with higher charges and longer stays in children's hospitals. Bronchoscopy and esophagoscopy were primary procedures.

Conclusions:

  • Pediatric airway and esophageal foreign bodies causing obstruction are infrequent but associated with a notable mortality rate.
  • Most affected children are treated at teaching institutions, indicating a need for specialized care.
  • Physician education on managing these potentially lethal conditions requires enhancement.
Abstract

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