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Hypoxaemia risk in pediatric flexible bronchoscopy for foreign body removal: a retrospective study

Su-Jing Zhang1,2, Min-Yi Lin1, Min Zhou1,2

  • 1College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Anesthesiology, Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center), Fujian Key Laboratory of Women and Children's Critical Diseases ReseFujian Medical Universityarch, Fuzhou, China.

BMC Pediatrics
|May 23, 2024
PubMed

Insights

Hypoxemia is common during pediatric foreign body (FB) removal via bronchoscopy. Longer operation times, larger FBs, and pneumonia increase this risk.

Area of Science:

  • Pediatric Pulmonology
  • Anesthesiology
  • Medical Device Safety

Background:

  • Hypoxemia is the most frequent adverse event during pediatric flexible bronchoscopy for foreign body (FB) removal.
  • Untreated hypoxemia can lead to cardiac or respiratory arrest.
  • Risk factors for hypoxemia during FB removal require further definition.

Purpose of the Study:

  • To identify specific risk factors associated with hypoxemia during flexible bronchoscopy for foreign body retrieval in pediatric patients.
  • To inform clinical practice and improve patient safety during these procedures.

Main Methods:

  • Retrospective analysis of 266 pediatric patients undergoing flexible bronchoscopy for FB extraction between January 1, 2015, and December 31, 2022.
  • Utilized supraglottic airway for anesthesia apparatus connection during procedures.
  • Employed multivariate analysis to determine significant risk factors for hypoxemia.

Main Results:

  • Hypoxemia occurred in 16.9% (45/266) of pediatric patients.
  • Significant risk factors for hypoxemia included: operation time >60 minutes (OR 8.55), maximum FB diameter >7 mm (OR 5.03), and pneumonia on imaging (OR 2.69).
  • These factors were identified through multivariate analysis with associated confidence intervals.

Conclusions:

  • Pediatric patients undergoing flexible bronchoscopy for FB removal are susceptible to hypoxemia.
  • Extended procedure duration, larger foreign body size, and presence of pneumonia are significant predictors of increased hypoxemia risk.
  • Identifying these risk factors can guide preventative strategies and management during bronchoscopy.
Abstract

Keywords:
Airway foreign bodyChildrenFlexible bronchoscopyHypoxemia

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