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Foreign Body Aspiration in Pediatric Airway: A Clinical Study
Grace Budhiraja1, Harsimrat Singh1, Danish Guram1
1Department of Otolaryngology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab 151001 India.
Insights
Foreign body aspiration (FBA) in children is common, often involving organic materials lodged in the right bronchus. Early diagnosis and management, including appropriate ventilation techniques, are crucial to prevent serious complications.
Area of Science:
- Pediatric Pulmonology
- Pediatric Anesthesiology
- Emergency Medicine
Background:
- Foreign body aspiration (FBA) poses significant risks for pediatric morbidity and mortality.
- Timely intervention is critical to minimize complications associated with airway foreign bodies.
Purpose of the Study:
- To analyze the types, clinical presentations, and impaction sites of foreign bodies in pediatric patients.
- To evaluate anesthetic considerations and ventilation strategies for pediatric FBA cases.
- To review outcomes of diagnostic and therapeutic bronchoscopy for FBA.
Main Methods:
- A retrospective study of 50 pediatric patients with FBA admitted to a tertiary care center.
- Data collection included patient history, foreign body characteristics, impaction site, and anesthetic management.
- Review of diagnostic and therapeutic bronchoscopy findings and procedure durations.
Main Results:
- Male children aged 1-3 years constituted the majority of FBA cases (44%).
- Common symptoms included cough, respiratory distress, and wheezing.
- Organic foreign bodies (73.9%) were most frequent, with the right bronchus being the most common site (64%).
- Jet ventilation was employed in all cases, with rigid bronchoscopy typically lasting under 15 minutes.
Conclusions:
- Foreign body aspiration remains a significant cause of preventable death and illness in children.
- Prompt diagnosis and management, tailored ventilation strategies, and bronchoscopic removal are essential.
- Understanding common foreign body types and locations aids in timely intervention and improved patient outcomes.
Abstract:
Immediate removal of foreign body (FB) can minimize the rate of complications. In the present study, we evaluated different types of foreign bodies, presenting clinical features amongst the children and their site of impaction. We also evaluated the anesthetic considerations during ventilation of pediatric airway in such Foreign body aspiration (FBA) patients. A retrospective study, for which prior Institutional Research Committee approval was taken, was conducted in 50 patients admitted in a tertiary care health centre. Relevant history regarding each patient's presenting symptoms or symptoms prior to hospitalization were recorded with special focus on interval between inhalation of foreign body and food intake. Each patient was examined for the nature and site of the foreign body. Appropriate method of ventilation for each case was discussed with the anesthesiologist before hand. Results of both therapeutic and diagnostic bronchoscopy were detailed. Majority of patients with foreign body aspiration (44%) were male children, between 1 and 3 years of age. The clinical features were mainly cough, respiratory distress and wheeze. Organic FB (73.9%) were the most common type of foreign body found. Right bronchus (64%) was the most common site of aspiration followed by left bronchus (24%). Jet ventilation was used in all the children, and duration of the rigid bronchoscopy was less than 15 min in majority of the cases. FBA are still dreaded as one of the leading causes of morbidity and mortality in infants and children that can be prevented by early diagnosis and management.
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