ABSTRACT
Foreign body impaction in airway is life-threatening as it can cause total airway obstruction. Such foreign bodies are removed under bronchoscopy in most patients. In some patients, however, the cardiopulmonary condition becomes unstable to undergo ventilating bronchoscopy under general anesthesia to remove the foreign body. In these conditions, extracorporeal membrane oxygenation (ECMO) can be adopted for cardiopulmonary support to stabilize the patient while removing the foreign body. ECMO supports tissue oxygenation and has been shown to improve survival of patients with adult respiratory distress syndrome. ECMO allows lungs to reserve their functions and decreases further lung injuries. The authors report one case of extensive tracheal inflammatory crust removed by ventilating bronchoscopy under tracheostomy and ECMO.
Subject(s)
Humans , Airway Obstruction , Anesthesia, General , Bronchoscopy , Burns, Inhalation , Extracorporeal Membrane Oxygenation , Foreign Bodies , Inhalation , Lung , Lung Injury , Oxygen , Respiratory Distress Syndrome , TracheostomyABSTRACT
Tension pneumothorax during ventilating bronchoscopy for foreign body removal is a rare but life-threatening complication. The authors present a case of cardiac arrest caused by tension pneumothorax in a 9-month-old girl who underwent ventilating bronchoscopy for foreign body (peanut) removal. Tension pneumothorax was due to tracheobronchial lacerations caused by a bronchoscope. The patient was successfully resuscitated by cardiopulmonary resuscitation and chest tube insertion. The airway injury was effectively repaired by thoracotomy under extracorporeal membrane oxygenation.
Subject(s)
Humans , Infant , Bronchoscopes , Bronchoscopy , Cardiopulmonary Resuscitation , Chest Tubes , Extracorporeal Membrane Oxygenation , Foreign Bodies , Heart Arrest , Lacerations , Pneumothorax , ThoracotomyABSTRACT
Tension pneumothorax is a rare complication during anesthesia and ventilating bronchoscopy. The authors have experienced a case of tension pneumothorax during ventilating bronchoscopy for removal of a foreign body(peanut) in the left mian bronches which caused cardiac arrest in a 22 month old pt. The patients was successfully resuscitated by CPR and closed thoracostomy. Subsequently the foreigh body was removed by bronchotomy.
Subject(s)
Humans , Infant , Anesthesia , Bronchoscopy , Cardiopulmonary Resuscitation , Heart Arrest , Pneumothorax , ThoracostomyABSTRACT
Seventy one children aged 3 months and 8 months with a foreign body in the airway were analysed. Most of the patients were less than 3 years of age, and male to female ratio 2.6:1. Most foreign bodies were food materials (58.2%), metallic bodies (20.9%) and plastic materials(13.4%). Of all the foreign bodies, 61 cases were lodged in the main bronchi and 3 cases were lodged in the larynx or trachea. Common symptoms and signs were cough, dyspnea, mild pyrexia, recurrent respiratory tract infection, decreased air entry, cyanosis and rales. The most common roentgenographic finding was obstructive emphysema (61.2%). A positive history of foreign body aspiration was obtained in 77.5% of the patients and it was found that carelessness of some sort is responsible in almost all the cases. Of the foreign bodies removed, 84.6% were done bronchoscopy. Direct laryngoscopy was performed in 4.6% of patients. Complications were involved in 19.7% of the cases with bronchoscopy. Three patients died of septic shock, asphyxia and hypoxic brain damage respectively.
Subject(s)
Child , Female , Humans , Male , Asphyxia , Bronchi , Bronchoscopy , Cough , Cyanosis , Dyspnea , Emphysema , Fever , Foreign Bodies , Hypoxia, Brain , Laryngoscopy , Larynx , Plastics , Respiratory Sounds , Respiratory Tract Infections , Shock, Septic , TracheaABSTRACT
Seventy one children aged 3 months and 8 months with a foreign body in the airway were analysed. Most of the patients were less than 3 years of age, and male to female ratio 2.6:1. Most foreign bodies were food materials (58.2%), metallic bodies (20.9%) and plastic materials(13.4%). Of all the foreign bodies, 61 cases were lodged in the main bronchi and 3 cases were lodged in the larynx or trachea. Common symptoms and signs were cough, dyspnea, mild pyrexia, recurrent respiratory tract infection, decreased air entry, cyanosis and rales. The most common roentgenographic finding was obstructive emphysema (61.2%). A positive history of foreign body aspiration was obtained in 77.5% of the patients and it was found that carelessness of some sort is responsible in almost all the cases. Of the foreign bodies removed, 84.6% were done bronchoscopy. Direct laryngoscopy was performed in 4.6% of patients. Complications were involved in 19.7% of the cases with bronchoscopy. Three patients died of septic shock, asphyxia and hypoxic brain damage respectively.