Foreign body aspiration.

Area of Science:

• Pulmonology
• Critical Care Medicine
• Interventional Bronchoscopy

Background:

• Foreign body (FB) aspiration presents a spectrum of clinical scenarios, from asymptomatic cases to life-threatening emergencies.
• Iatrogenic FBs, such as broken teeth or instruments, are common in intensive care units (ICUs), often leading to post-obstructive pneumonia or hemoptysis.

Purpose of the Study:

• To review the clinical manifestations, diagnostic approaches, and management strategies for foreign body aspiration.
• To highlight the evolving role of flexible bronchoscopy and various instrumentation techniques in foreign body retrieval.

Main Methods:

• Review of clinical presentations and management of foreign body aspiration.
• Description of flexible bronchoscopy techniques and instruments (forceps, balloon catheters, baskets, cryoprobe, LASER).
• Discussion of airway management, post-retrieval care, and alternative surgical interventions.

Main Results:

• Flexible bronchoscopy is now the primary modality for most foreign body removals, surpassing traditional rigid bronchoscopy.
• Various instruments allow for successful retrieval of foreign bodies, with larger ones sometimes requiring en bloc removal with airway components.
• Post-retrieval bronchoscopy is crucial for assessing airway injury and managing complications; surgery may be necessary if bronchoscopy fails.

Conclusions:

• Flexible bronchoscopy, utilizing a range of instruments, is highly effective for managing foreign body aspiration and its complications.
• A multidisciplinary approach involving intensivists, surgeons, and anesthesiologists is essential for optimal patient outcomes in foreign body aspiration cases.