Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Professional Medical Publications
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objectives: Delayed diagnosis and treatment of tracheobronchial foreign body aspiration (FBA) in children may lead to morbidity and mortality. Our objective was to evaluate the anesthetic management, periand post-operative complications, and predisposing factors for postoperative intensive care unit (ICU) admission in children undergoing rigid bronchoscopy due to tracheobronchial FBA. Methods: This retrospective study included 81 children who underwent rigid bronchoscopy between January 2010 to July 2018 at Inonu University, Department of Pediatric Surgery, Turkey. Data regarding demographic characteristics, anesthetic management, length of ICU and hospital stays, and peri- and postoperative complications were retrieved from the hospital database. Results: The patients included 54 (66.7%) boys and 27 (33.3%) girls with a mean age of 29.6 +/- 31.2 months. The most common presenting symptom was the suspicion of FBA, followed by acute-onset cough, cyanosis, wheezing and respiratory distress. Mean duration of anesthesia was 44.40 +/- 14.72 min. Of the 81 patients, 18 (22.2%) were transferred to ICU and 63 (77.8%) patients were transferred to the ward postoperatively. Of the patients transferred to the ICU, 5 of them required mechanical ventilation. Some peri and postoperative complications, desaturation (n=16; 19.7%; p=0.001), mucosal bleeding (n=6; 7.4%; p=0.02), laryngeal edema (n=11; 13.6%; p<0.001), laryngospasm (n=13; 16.3%; p<0.001), were affected the frequency of intensive care transfer. Conclusion: Bronchoscopy with general anesthesia remains the golden standard for the management of tracheobronchial FBA. In such patients, a combination consisting of a detailed preoperative clinical evaluation of the patient, selection of short-acting anesthetic agents with minimal side effects for the induction and maintenance of anesthesia, and the administration of controlled ventilation can be recommended. Additionally, early diagnosis of peri- and post-operative complications, prediction of postoperative ICU requirement, and a close cooperation of anesthesiologists and surgeons are highly important.
Açıklama
Anahtar Kelimeler
Anesthetic management, Bronchoscopy, Complications, Intensive care, Tracheobronchial foreign body
Kaynak
Pakistan Journal of Medical Sciences
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
35
Sayı
6
