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Rigid and Flexible Bronchoscopy for Foreign Body Removal in Children: Complications, Risk Factors and Anesthetic
Oliver Keil1, Yehor Huzhva1, Vanessa Rigterink1
1Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
Pediatric Pulmonology
|August 22, 2025
Summary
Flexible bronchoscopy is a safer and more effective method for foreign body removal (FBR) in children, associated with fewer complications than rigid bronchoscopy. Anesthetic management is crucial for pediatric FBR.
Area of Science:
- Pediatric Anesthesiology
- Pediatric Pulmonology
- Emergency Medicine
Background:
- Foreign body (FB) aspiration is a common pediatric emergency with potential for severe outcomes.
- Data on anesthetic management and complications for FB removal (FBR), especially with flexible techniques, is limited.
Purpose of the Study:
- To analyze complication rates and risk factors for rigid versus flexible bronchoscopy in pediatric FBR.
- To evaluate anesthetic management strategies for FBR in children.
Main Methods:
- Retrospective analysis of 160 pediatric bronchoscopies for suspected FB aspiration.
- Comparison of complication rates and risk factors between rigid and flexible bronchoscopy techniques.
Main Results:
- Flexible bronchoscopy was increasingly utilized, with lower complication rates (1.29/patient) compared to rigid bronchoscopy (2.19/patient).
- Rigid bronchoscopy and pre-existing airway infections were independent risk factors for severe complications.
- Total intravenous anesthesia and laryngeal mask airway were preferred for flexible bronchoscopy.
Conclusions:
- Flexible bronchoscopy is a safe, fast, and successful tool for pediatric FBR with fewer adverse events.
- Experienced pediatric anesthetic management is essential for minimizing FBR complications.
- Rigid bronchoscope use and airway infections increase the risk of severe complications during FBR.
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