Application of upper limbs-raised position in CT examination of airway foreign body in children / 中华放射医学与防护杂志

Objective To confirm the effect of the relative position between upper limbs and cervicothoracic vertebrae on image quality and radiation dose while performing airway CT examination of children with airway foreign bodies. Methods One hundred and three children, aged from 1 to 48 months were enrolled prospectively and divided into 3 groups according to the position of upper limbs. In group A, the upper limbs were raised beside the cervical vertebra, in group B, the upper limbs were placed beside the thoracic vertebra, and in group C, the upper limbs were raised about 45 degrees with sponge pads and placed beside the chest. Data were acquired by Philips 128iCT, and CT dose index (CTDIvol ) and dose-length product ( DLP ) were recorded and compared among three groups. The image qualities were evaluated subjectively and objectively. Results Subjective score of cervical image quality in group B (4. 33±0. 72) and group C (4. 19± 0. 63) were higher than that in group A (3. 71 ± 0. 66), and the difference was statistically significant (Z = -3. 19、 -2. 61, P<0. 05) . Subjective score of chest image quality in group A (4. 21±0. 47) was higher than that in group B (3. 71± 0. 39) and group C (3. 92± 0. 42), and group C was higher than that in group B, the difference was statistically significant ( Z =-1. 71, -2. 08, P<0. 05). The difference of DLP in group B (57. 7±6. 8) mGy·cm was higher than that in group A (51. 6±7. 6) mGy·cm and group C (51. 3±6. 3) mGy·cm, the difference was statistically significant (P<0. 05), and there was no significant difference between group A and group C (P>0. 05). Conclusions Raising upper limbs 45 degrees and placing them beside the chest will improve the CT image quality of airway and reduce the radiation dose.

Application of upper limbs-raised position in CT examination of airway foreign body in children / 中华放射医学与防护杂志

Objective@#To confirm the effect of the relative position between upper limbs and cervicothoracic vertebrae on image quality and radiation dose while performing airway CT examination of children with airway foreign bodies.@*Methods@#One hundred and three children, aged from 1 to 48 months were enrolled prospectively and divided into 3 groups according to the position of upper limbs.In group A, the upper limbs were raised beside the cervical vertebra, in group B, the upper limbs were placed beside the thoracic vertebra, and in group C, the upper limbs were raised about 45 degrees with sponge pads and placed beside the chest. Data were acquired by Philips 128iCT, and CT dose index (CTDIvol) and dose-length product (DLP) were recorded and compared among three groups. The image qualities were evaluated subjectively and objectively.@*Results@#Subjective score of cervical image quality in group B (4.33±0.72) and group C (4.19±0.63) were higher than that in group A (3.71±0.66), and the difference was statistically significant (Z=-3.19、-2.61, P<0.05). Subjective score of chest image quality in group A (4.21±0.47) was higher than that in group B (3.71±0.39) and group C (3.92±0.42), and group C was higher than that in group B, the difference was statistically significant (Z= -1.71, -2.08, P<0.05). The difference of DLP in group B (57.7±6.8) mGy·cm was higher than that in group A (51.6±7.6) mGy·cm and group C (51.3±6.3) mGy·cm, the difference was statistically significant (P<0.05), and there was no significant difference between group A and group C (P>0.05).@*Conclusions@#Raising upper limbs 45 degrees and placing them beside the chest will improve the CT image quality of airway and reduce the radiation dose.

Airway foreign bodies: A critical review for a common pediatric emergency / 世界急诊医学杂志（英文）

@#BACKGROUND:Airway foreign bodies (AFBs) is an interdisciplinary area between emergency medicine, pediatrics and otolaryngology. It is a life-threatening condition that is not infrequently seen; however, it is poorly covered in medical literature. Accidental aspiration of an element into airways is a widespread clinical scenario among children under 3 years, predominantly males. Moreover, it is the leading cause of infantile deaths and the fourth one among preschool children. DATA RESOURCES:A systemic search was conducted in July 2015 using PubMed/PubMed Central Database of The National Center for Biotechnology Information (NCBI) (http://www.ncbi.nlm. nih.gov/). A total of 1767 articles were identified and most of them were meta-analyses, systematic reviews, and case series. Those thoroughly discussing assessment and management of AFBs were retrieved. RESULTS:AFBs episodes may be either witnessed or missed. Presence of a witness for the inhalation is diagnostic. The later usually present with persistent active cough. A classical triad of paroxysmal cough, wheezing, and dyspnoea/decreased air entry was reported, though many presentations have inconsistent findings. Hence, diagnosis requires high index of clinical suspicion. Flexible fibro-optic bronchoscopy is the gold standard of diagnosis, whereas inhaled objects are best retrieved by rigid bronchoscopes. CONCLUSIONS:Close supervision of pediatrics is the hallmark of prevention. Caregivers should ensure a safe surrounding milieu, including the toys their offspring play with. Immediate complications result from direct obstruction or injury by the inhaled object. Alternatively, prolonged lodging traps air and induces inflammatory response causing atelectesis and pneumonia, respectively.