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Identifying predictive factors for long-term complications following button battery impactions: A case series and
Michael J Eliason1, Jonathan M Melzer1, Jessica R Winters1
1Naval Medical Center Portsmouth, Department of Otolaryngology, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA.
Insights
Button battery impactions in children can cause long-term complications. Identifying factors like impaction time and battery pole direction can help predict and minimize these serious outcomes.
Area of Science:
- Pediatric Otolaryngology
- Medical Device Safety
- Clinical Protocol Development
Background:
- Button battery impactions in the aerodigestive tract pose significant risks to pediatric patients.
- Current management protocols require refinement to address potential long-term sequelae.
- A comprehensive review of clinical cases and laboratory research is needed to optimize care.
Observation:
- Eight pediatric patients with button battery impactions were reviewed.
- Two patients experienced long-term complications following impaction.
- The median impaction time was 10.5 hours, with a median patient age of 33 months.
Findings:
- Key predictive factors for long-term complications include impaction duration, the battery's negative pole orientation, and specific battery characteristics.
- These factors can guide clinical decision-making for pediatric otolaryngologists.
- Early identification of risk factors is crucial for effective management.
Implications:
- Developing a standardized protocol based on identified predictive factors can minimize catastrophic sequelae.
- Advancements in battery technology and research inform improved patient care strategies.
- This research supports proactive management to prevent severe outcomes from button battery ingestions.
Objectives:
To complement a case series review of button battery impactions managed at our single military tertiary care center with a thorough literature review of laboratory research and clinical cases to develop a protocol to optimize patient care. Specifically, to identify predictive factors of long-term complications which can be used by the pediatric otolaryngologist to guide patient management after button battery impactions.
Methods:
A retrospective review of the Department of Defense's electronic medical record systems was conducted to identify patients with button battery ingestions and then characterize their treatment course. A thorough literature review complemented the lessons learned to identify potentially predictive clinical measures for long-term complications.
Results:
Eight patients were identified as being treated for button battery impaction in the aerodigestive tract with two sustaining long-term complications. The median age of the patients treated was 33 months old and the median estimated time of impaction in the aerodigestive tract prior to removal was 10.5 h. Time of impaction, anatomic direction of the battery's negative pole, and identifying specific battery parameters were identified as factors that may be employed to predict sequelae.
Conclusion:
Based on case reviews, advancements in battery manufacturing, and laboratory research, there are distinct clinical factors that should be assessed at the time of initial therapy to guide follow-up management to minimize potential catastrophic sequelae of button battery ingestion.
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