Controlled vs Spontaneous Ventilation for Bronchoscopy in Children with Tracheobronchial Foreign Body

Authors

  • Ali Jafarzadeh Esfehani Medical School and Neonatal Research Center, NICU of Emamreza Hospital, Mashhad University of Medical Science, Iran.
  • Alireza Sabzevari Department of Anaesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran
  • kamran khazaeni Department of Otolaryngology, Head and Neck Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Leila Mashhadi Department of Anaesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Marjan Joodi Department of Paediatric Surgery, Sarvar Children’s Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Maryam Salehi Research Center for Patient Safety, Mashhad University of Medical Sciences, Mashhad, Iran. and Clinical Research Unit, Ghaem hospital, Faculty of Medicine, Mashhad University of Medical Sciences.
  • Mehdi Fathi Department of Anaesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Reza Shojaeian Department of Paediatric Surgery, Sarvar Children’s Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract:

Introduction Tracheobronchial foreign body aspiration is a common life-threatening condition in children. There are controversies in the management of this condition, including the type of ventilation during bronchoscopy.  This study aims to compare anesthesia with controlled ventilation versus spontaneous ventilation in rigid bronchoscopy in children with foreign body aspiration.  Materials and Methods: Patients who were candidates for rigid bronchoscopy due to foreign body aspiration were randomly assigned to either anesthesia with spontaneous ventilation or controlled ventilation. End tidal CO2 (ETCO2), electrocardiogram (ECG), heart rate (HR), oxygen saturation (SpO2), non-invasive blood pressure (NIBP) and complications and accidents during the surgery and recovery were recorded for each patient. Surgeon comfort during the procedure was also evaluated for each patient. A 20% change in HR or NIBP was considered significant. SpO2 values under 90% are considered desaturation.  Results: Fifty-one patients (31 male and 20 female) entered the study. The mean age was 26.76 months, ranging from 6 to 100 months. Choking and cough were present in 94% and 96.1% of the patients, respectively. Nuts were the most common foreign body (76.9%). The controlled ventilation group had significantly fewer complications, and surgeon comfort was significantly higher in this group. Oxygen desaturation was significantly more prevalent in the spontaneous ventilation group during laryngoscopy and bronchoscopy (P

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Journal title

volume 29  issue 6

pages  333- 340

publication date 2017-11-01

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