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Risk factors for prolonged surgical duration of tracheobronchial foreign body removal in children: a single-center
Zhe Su1, Jianmin Zhang1, Zhengzheng Gao1
1Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Factors like American Society of Anesthesiologists (ASA) III status, pulmonary rales, and tracheobronchial inflammation significantly prolong rigid bronchoscopic foreign body removal surgery in children.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Respiratory Medicine
Background:
- Tracheobronchial foreign body aspiration is a common emergency in children.
- Rigid bronchoscopy under general anesthesia is the standard treatment.
- Predicting and minimizing surgical duration is crucial for patient outcomes.
Purpose of the Study:
- To analyze clinical characteristics of pediatric tracheobronchial foreign body cases.
- To identify factors influencing surgical duration during rigid bronchoscopic removal.
Main Methods:
- Retrospective analysis of 421 children undergoing rigid bronchoscopy (Jan 2020-Dec 2021).
- Data collected: demographics, foreign body details, symptoms, bronchoscopic findings, and surgical duration.
- Univariate and multivariate linear regression models used to identify risk factors for prolonged surgery.
Main Results:
- Mean age was 1.59 years; 96.7% were ASA II.
- Organic foreign bodies (94.8%) were most common, predominantly unilateral (91.7%).
- ASA III status, pulmonary rales, and specific tracheobronchial manifestations (hyperemia, edema, exudate, granulation tissue) were independent risk factors for longer surgical duration (P < 0.05).
Conclusions:
- Pediatric patients with ASA III classification, pulmonary rales, and visible tracheobronchial inflammation require careful surgical planning.
- These factors are significantly associated with prolonged operative times in foreign body removal.
- Understanding these predictors can help optimize surgical management and reduce complications.
Object:
This study aims to analyze the clinical characteristics of children with tracheobronchial foreign body and to investigate the factors influencing the surgical duration of rigid bronchoscopic foreign body removal under general anesthesia.
Methods:
We retrospectively identified 421 children diagnosed with tracheobronchial foreign body undergoing rigid bronchoscopy between January 2020 and December 2021. A comprehensive analysis was conducted on patient demographics, including age, weight, gender, American Society of Anesthesiologists (ASA) physical status classification, foreign body type and location, duration of foreign body retention, preoperative symptoms, signs, imaging findings, tracheobronchial manifestations observed during bronchoscopy, and surgical durations. Statistical analysis utilized both univariate and multivariate linear regression models to assess factors influencing the surgical duration of tracheobronchial foreign body removal in children.
Results:
The mean age of children with tracheobronchial foreign body was 1.59 years (1.32, 2.04). The male-to-female ratio was 1.8:1, and the ASA physical status classification was predominantly ASA II (96.7%). Organic foreign body accounted for 94.8% of cases, with 91.7% located unilaterally. Univariate and multivariate linear regression analyses revealed that ASA III, pulmonary rales, and the presence of one, two, or three specific tracheobronchial manifestations observed during bronchoscopy-including mucosal hyperemia and edema, purulent exudate, and granulation tissue-were independent risk factors associated with prolonged surgical duration for foreign body removal (P < 0.05).
Conclusion:
ASA III, pulmonary rales, and various tracheobronchial manifestations observed during bronchoscopy are significant risk factors associated with prolonged surgical duration for foreign body removal in children.
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