Rigid bronchoscopies in pediatric patients with tracheobronchial foreign bodies: Our outcomes

Sum mary Aim: Tracheal or bronchial foreign body aspiration is a life-threatening emergency in children requiring immediate bronchoscopy under general anesthesia. The aim of this retrospective study was to evaluate the anesthetic management, hazards and complications of bronchoscopies performed because of suspicion of foreign body aspiration. Material and Method: We retrospectively analyzed the history, clinical and radiological findings and complications of 401 children admitted to the pediatric surgery department due to suspicion of foreign body aspiration between January 2006 and June 2011. Children requiring diagnostic bronchoscopies were excluded. All brochoscopies were performed under general anesthesia. Inhalation or IV induction and maintenance, spontaneous or controlled mechanical ventilation were selected individually according to the circumstances. Clinical findings, physical examination, radiological findings, anesthesia methods and complications of the patients were evaluated. Results: Cough (82%) and dyspnea (21.8%) were common symptoms of tracheobronchial foreign bodies. Most common radiological findings included air trapping (57%) and normal chest radiographs (21%). The aspirated foreign bodies were generally organic materials (80%) such as nuts, peanuts and seeds. The majority of foreign bodies lodged in the bronchial tree and the incidence of right sided (49.1%) foreign bodies was higher than that of the left sided (24.4%). Major complications during the anesthesia and postoperative period were desaturation, arrhythmia, hypercarbia and bronchospasm. Conclusions: Many problems can be experienced in children with inhaled foreign bodies. Bronchoscopy must be performed under optimal conditions in these patients. (Turk Arch Ped 2012; 47: 126-30)