1
|
Cai H, Gao J. Clinical analysis of special types of tracheobronchial foreign bodies in children. Front Pediatr 2024; 12:1395629. [PMID: 39086627 PMCID: PMC11288900 DOI: 10.3389/fped.2024.1395629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Objectives To explore the clinical diagnosis and treatment of special types of tracheobronchial foreign bodies in children and provide a reference for clinicians to formulate treatment plans. Methods Clinical data of 29 children with special types of tracheobronchial foreign bodies who were treated at The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between June 2017 and June 2022 were collected and analyzed, and their diagnosis and treatment processes were reviewed. Results All 29 special types of foreign bodies were successfully removed using rigid bronchoscopy under general anesthesia, with no surgical complications. Conclusions and significance For the treatment of special types of tracheobronchial foreign bodies, clinicians should make detailed surgical plans and select appropriate instruments according to different conditions to improve the surgical success rate and reduce the occurrence of complications.
Collapse
Affiliation(s)
| | - Jinjian Gao
- Department of Otorhinolaryngology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| |
Collapse
|
2
|
Rajabzadeh F, Akhlaghipour I, Moosavi SS, Nasimi Shad A, Babazadeh Baghan A, Shariati‐Sarabi Z, Payandeh A, Hassan Nejad E. Comparison of the intima-media thickness of the common carotid artery in patients with rheumatoid arthritis: A single-center cross-sectional case-control study, and a brief review of the literature. Health Sci Rep 2023; 6:e1718. [PMID: 38028704 PMCID: PMC10654376 DOI: 10.1002/hsr2.1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/26/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aim Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease affecting 0.5%-1% of adults worldwide. The carotid intima-media thickness (CIMT) is a simple, reliable, noninvasive marker for subclinical atherosclerosis. The aim of this study was to compare the intima-media thickness of the common carotid artery in patients with RA with that of healthy patients. Methods In this case-control study, subjects were recruited from the patients who presented to a private rheumatology clinic. RA was documented by a rheumatologist. All subjects underwent an ultrasound examination of the carotid artery to assess CIMT. Subjects with RA filled out the disease activity score (DAS28) questionnaire. Results Sixty-two subjects (31 subjects with RA and 31 healthy subjects) took part in the study. The mean age of the subjects in the RA and the control groups was 42.39 ± 12.98 and 44.48 ± 13.56 years, respectively. Values of CIMT were significantly greater in RA subjects compared with their healthy counterparts (p < 0.001). The CIMT increased significantly with increased disease severity (r = 0.73). Subjects were divided into two age groups (≤40 and >40 years). A comparison of CIMT in the mentioned subgroups revealed a remarkable difference in CIMT values between those of the RA patients and those of their control counterparts in both age groups (p = 0.002 and p < 0.001 for those below and above 40 years, respectively). Conclusion CIMT could be used as an efficient clinical index for identifying the early stages of atherosclerosis and predicting cardiovascular events following atherosclerosis in RA patients.
Collapse
Affiliation(s)
- Farnood Rajabzadeh
- Department of Radiology, Faculty of Medicine, Mashhad Medical SciencesIslamic Azad UniversityMashhadIran
| | - Iman Akhlaghipour
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Arya Nasimi Shad
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Atefeh Babazadeh Baghan
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Asma Payandeh
- Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Ehsan Hassan Nejad
- Department of Radiology, School of MedicineBirjand University of Medical SciencesBirjandIran
| |
Collapse
|
3
|
Zhang Z, Zhang M, Xu Y, Lu M, Zhang L, Li C. Effect of Astragaloside IV on improving cardiac function in rats with heart failure: a preclinical systematic review and meta-analysis. Front Pharmacol 2023; 14:1226008. [PMID: 37854719 PMCID: PMC10579795 DOI: 10.3389/fphar.2023.1226008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/21/2023] [Indexed: 10/20/2023] Open
Abstract
Background: Astragaloside IV (ASIV) is the primary pharmacologically active compound found in Astragalus propinquus Schischkin, which has potential protective effects on cardiac function. However, there are almost no systematic evaluations of ASIV for the treatment of heart failure (HF). Methods: Preclinical studies published before 27 December 2022, were retrieved from PubMed, Web of Science, MEDLINE, SinoMed, Chinese National Knowledge Infrastructure (CNKI), VIP information database, and Wanfang Data information site. The quality of included research was evaluated using SYRCLE's RoB tool. Review Manager 5.4.1 was used to perform meta-analyses of the cardiac function parameters and other indicators. Regression analysis was conducted to observe the dose-efficacy relationship. Results: Nineteen studies involving 489 animals were included. Results indicated that compared with the control group, ASIV could enhance cardiac function indicators, including left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular pressure change rate (±dp/dtmax), left ventricular end-diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), heart weight/body weight (HW/BW) and left ventricular weight/body weight (LVW/BW). Furthermore, the regression analysis showed that the treatment of HF with ASIV was dose-dependent. Conclusion: Findings suggest that ASIV can inhibit cardiac hypertrophy by reducing cardiac preload and afterload, thereby protecting cardiac function.
Collapse
Affiliation(s)
- Zhiyuan Zhang
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Muxin Zhang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongkai Xu
- Department of Peripheral Vascular Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mengkai Lu
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lei Zhang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chao Li
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| |
Collapse
|
4
|
Favre NM, Powers KF, Viola FC, Carr MM. Foreign Body Aspiration Complicated by Pneumothorax in Children: HCUP-KID Perspective. Ann Otol Rhinol Laryngol 2023; 132:1222-1227. [PMID: 36582149 DOI: 10.1177/00034894221140775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Children with airway foreign bodies (AFB) occasionally have pneumothorax complicating their course. We aimed to compare the clinical course of these children to those without this complication. METHODS Data was obtained from the 2016 Kids' Inpatient Database of Healthcare Cost Utilization Project. ICD-10 code of T17XXXX was used to locate records. They were grouped based on the presence of preoperative pneumothorax, postoperative pneumothorax, or none. Variables included demographics, AFB type, AFB location, length of stay (LOS), pneumothorax treatment modality, mortality, hospital setting, primary payor, and total charges. RESULTS A total of 4165 children with AFB were identified, 57.8% male and 42.2% female. Of these 75 (1.8%) patients presented with preoperative pneumothorax, 29 (0.7%) with postoperative pneumothorax, and 4061 (97.5%) with no pneumothorax. The preoperative pneumothorax patients were older than the postoperative pneumothorax and unaffected AFB patients (mean age = 9.5 [95% CI 7.7-11.3] vs 8.2 [95% CI 5.4-11.1] vs 5.5 [95% CI 5.3-5.7]; P < .001). Preoperative pneumothorax patients incurred higher total charges than the other groups (mean US = $939K [95% Cl 673K-1,204K] vs $599K [95% Cl 377K-821K] vs $228K [95% Cl 211K-244K]; P < .001), had a longer LOS in days (mean = 37.7 [95% Cl 28.7-46.7] vs 31.6 [95% Cl 16.9-46.2] vs 15.8 [95% CI 15.0-16.7]; P < .001), and had a higher mortality rate (16% vs 0% vs 3.7%, P < .001). CONCLUSION Pneumothorax can significantly impact a child's hospital course, and preoperative pneumothorax should alert clinicians to the potential for increased mortality risk.
Collapse
Affiliation(s)
- Nicole M Favre
- Department of Otolaryngology-Head and Neck Surgery, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| | - Kristina F Powers
- Department of Otolaryngology-Head and Neck Surgery, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| | - Francesca C Viola
- Department of Otolaryngology-Head and Neck Surgery, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| | - Michele M Carr
- Department of Otolaryngology-Head and Neck Surgery, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| |
Collapse
|
5
|
Wang Y, Sun Y, Zhang H, Yang X, Song X. Comprehensive Analysis of the Diagnosis and Treatment of Tracheobronchial Foreign Bodies in Children. EAR, NOSE & THROAT JOURNAL 2023; 102:661-666. [PMID: 34112007 DOI: 10.1177/01455613211023019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To analyze the factors influencing the diagnosis and treatment of tracheobronchial foreign bodies (TFBs) in children. METHODS The clinical data of 300 consecutive children with suspected TFBs who were admitted to our department between January 2016 and December 2019 were retrospectively collected, including demographics, diagnosis, history of foreign body inhalation, preoperative chest computed tomography (CT) findings, duration of foreign body retention, time from admission to operation, operation duration, duration of hospitalization, and complications. RESULTS Among the 300 cases, the male:female ratio was 193:107, and the age range was 6 months to 12 years (median age: 19 months). A total of 291 cases (97.0%) involved TFBs confirmed by rigid bronchoscopy, while the other 9 cases (3.0%) involved bronchopneumonia. The diagnostic accuracy, sensitivity, and specificity of a history of foreign body inhalation and chest CT were 96.0%, 98.6%, and 11.1% and 97.7%, 97.6%, and 100%, respectively. The duration of hospitalization, time from admission to operation, and operation duration were all related to bronchopneumonia (P < .05). CONCLUSIONS A detailed history, adequate physical examination, and preoperative imaging examination help improve the diagnostic accuracy. Preoperative bronchopneumonia in children with TFBs will increase the surgical risks and treatment costs, prolonging the duration of hospitalization.
Collapse
Affiliation(s)
- Yan Wang
- Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Yan Sun
- Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Hua Zhang
- Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Xin Yang
- Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Xicheng Song
- Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| |
Collapse
|
6
|
Wu Y, Zhang X, Lin Z, Ding C, Wu Y, Chen Y, Wang D, Yi X, Chen F. Changes in the global burden of foreign body aspiration among under-5 children from 1990 to 2019. Front Pediatr 2023; 11:1235308. [PMID: 37727616 PMCID: PMC10506258 DOI: 10.3389/fped.2023.1235308] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
Background To evaluate the changes in the global burden of foreign body aspiration (FBA) among children under 5 years old at regional, age, sex, and socio-demographic index (SDI) levels between 1990 and 2019. Methods Data on FBA was derived from the Global Burden of Disease (GBD) Study 2019 database on pulmonary aspiration and foreign body in airway. The means and 95% uncertainty intervals (UIs) were calculated for incidence, and disability-adjusted life-years (DALYs). The temporal trends were represented by estimated annual percentage change (EAPC) using Joinpoint regression. Results Globally, FBA caused 109.6 (95% UI: 69.5, 175.7) per 100,000 incidence and 317.9 (95% UI: 270.7, 372.4) per 100,000 DALYs under 5 years old in 2019. Many European countries (such as Italy, Netherlands, Iceland, etc.) showed a high incidence rate, but did not cause a large disease burden (DALYs all less than 200 per 100,000). Compared to 1990, although a decrease in both incidence and DALYs occurred in 2019, the Joinpoint regression showed an increasing trend in incidence rate from 2014 to 2019 [APC: both (2.10), female (2.25), male (1.98), P < 0.05)], especially China, Netherlands, and Malta. Despite the lower incidence rate in early neonatal group and middle SDI areas, they instead resulted in higher DALYs than other age groups and areas. Conclusion Although declines occurred in incidence and DALYs of FBA among children under 5 years of age from 1990 to 2014, an upward trend began to emerge from 2014 to 2019. The incidence and DALY rates were correlated with age and SDI. Increased efforts are needed to improve the necessary monitoring and reporting systems, hazard assessment, and public education activities.
Collapse
Affiliation(s)
- Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xin Zhang
- Fujian Branch of Shanghai Children’s Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children’s Hospital, Fujian Medical University, Fuzhou, China
| | - Zaigang Lin
- Laboratory Animal Center, Fujian Medical University, Fuzhou, China
| | - Chenyu Ding
- Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yuxuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yue Chen
- Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Desheng Wang
- Department of Otolaryngology Head and Neck Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xuehan Yi
- Department of Otolaryngology Head and Neck Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Fa Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
| |
Collapse
|
7
|
Chantzaras A, Panagiotou P, Karageorgos S, Douros K. A systematic review of using flexible bronchoscopy to remove foreign bodies from paediatric patients. Acta Paediatr 2022; 111:1301-1312. [PMID: 35388522 DOI: 10.1111/apa.16351] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 12/23/2022]
Abstract
AIM Our aim was to summarise the evidence about flexible bronchoscopy for paediatric airway foreign body aspiration cases. METHODS We searched the PubMed database from 1 January 2001 to 9 October 2021 for peer-review papers published in English on the use, and success rates, of flexible bronchoscopy as the first-line treatment for foreign body aspiration cases. This process identified 243 potential papers. RESULTS We studied 23 papers comprising 2588 cases of foreign body aspiration and flexible bronchoscopy successfully removed the foreign bodies in 87.1% of cases. Complication rates were low in the 983 patients studied in 18 papers. The foreign bodies were organic materials in 78.3% of 1371 patients and mainly lodged in the right bronchial tree in 50.5% of 1402 patients. General anaesthesia was used before flexible bronchoscopy in 14/23 studies and laryngeal mask airways were mostly used in 10/23 studies to secure the airway during the procedure. Ancillary equipment was used to assist the foreign body removal in 57.3% of 1808 cases and these were usually baskets. CONCLUSION Flexible bronchoscopy was a feasible and safe therapeutic procedure for selected foreign body aspiration cases. Future studies need to focus on comparing the clinical outcomes of flexible and rigid bronchoscopies.
Collapse
Affiliation(s)
| | - Panagiota Panagiotou
- First Department of Pediatrics Aghia Sophia Children’s Hospital National and Kapodistrian University of Athens Athens Greece
- Evelina London Children’s Hospital London UK
| | - Spyridon Karageorgos
- First Department of Pediatrics Aghia Sophia Children’s Hospital National and Kapodistrian University of Athens Athens Greece
| | - Konstantinos Douros
- Pediatric Allergy and Respiratory Unit 3rd Department of Paediatrics School of Medicine Attikon University Hospital National and Kapodistrian University of Athens Athens Greece
| |
Collapse
|
8
|
Zewdu D, Wondwosen M, Chufamo M, Eanga S, Aga A, Ewnte B, Hunie M, Teshome D. The practice of foreign body removal from the ear, nose, and upper esophageal in children in Ethiopia: A retrospective descriptive study. Laryngoscope Investig Otolaryngol 2021; 6:1316-1320. [PMID: 34938868 PMCID: PMC8665465 DOI: 10.1002/lio2.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/24/2021] [Accepted: 10/18/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Ear, nose, and upper esophageal foreign body (FB) impaction in children is a common emergency in-hospital service. There are no clear guidelines regarding the management of ingested FBs. This study aimed to determine the FB in terms of type, anatomic site, management outcome, and associated complications. METHODS Retrospective study of children with ear, nose, and upper esophageal FB managed under general anesthesia (GA) at operating room of Wolkite Hospital in the southern part of Ethiopia between January 2019 and February 2021. Data were collected from the medical chart of the patients using a prepared checklist. The parameters included were age, sex, FB anatomic site, type, management outcome, and associated complications related to FB or procedure modalities. RESULTS A total of 169 (31.4%) study subjects were required GA for the removal of FBs. The mean age was 4.45 ± 3.20 years. Under 5 years old children comprises 61.5% of total cases. The most common anatomic site of FB impaction was in the ear 97 (57.4%). The most commonly found type of FB was cereals or seeds, which constituted 102 (60.35%). The complication rate was 18.35%. Epistaxis was the commonest complication (6.51%) from the nose while canal abrasion (5.92%) was common from the ear. CONCLUSION Ear, nose, and upper esophageal FBs were found more frequently in younger children. The ear was the most common anatomic site of FB impaction followed by the nose and upper esophageal. The most common type of FB was cereals or seeds. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- Dereje Zewdu
- Department of Anesthesia, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Mekete Wondwosen
- Department of Surgery, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Mulatu Chufamo
- Department of Surgery, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Shamill Eanga
- Department of Anesthesia, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Abdisa Aga
- Department of AnesthesiaHarar College of Health ScienceHararEthiopia
| | - Biniam Ewnte
- Department of Surgery, College of Medicine and Health ScienceDebre Tabor UniversityDebre TaborEthiopia
| | - Metages Hunie
- Department of Anesthesia, College of Health ScienceDebre Tabor UniversityDebre TaborEthiopia
| | - Diriba Teshome
- Department of Anesthesia, College of Health ScienceDebre Tabor UniversityDebre TaborEthiopia
| |
Collapse
|
9
|
Chang DT, Abdo K, Bhatt JM, Huoh KC, Pham NS, Ahuja GS. Persistence of choking injuries in children. Int J Pediatr Otorhinolaryngol 2021; 144:110685. [PMID: 33819896 DOI: 10.1016/j.ijporl.2021.110685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/18/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Choking injuries are a significant cause of morbidity and mortality in children and represent a significant public health concern. Evaluating trends and the impact of interventions are essential to highlight whether progress has been made and to target public health efforts. OBJECTIVE To investigate how rates of nonfatal and fatal choking injuries have changed before and after 2010 when policy recommendations were made by the American Academy of Pediatrics. METHODS A descriptive study investigating unintentional nonfatal and fatal choking injuries in children aged 0-19 years using national data from 2001 to 2016 through the Centers for Disease Control and Prevention's WISQARS™ and WONDER databases, focusing on the 6 years prior and 6 years after release of the AAP's recommendations. The data was categorized by age, gender, year, and race/ethnicity for descriptive and statistical analyses. RESULTS From 2001 to 2016, there were a total of 305,814 nonfatal injuries and 2347 choking deaths in children from 0 to 19 years. Children under five years of age accounted for 73% of nonfatal injuries and 75% of choking fatalities. There was a statistically significant increase in the nonfatal injuries rate when comparing 2005-2010 and 2011-2016 (19/100,000 versus 26/100,000, respectively). There was a decrease in the choking fatalities rate in all children (0.18/100,000 versus 0.16/100,000, respectively) but no change in fatalities rate for children under five. White and Black children experience nonfatal choking injuries at a higher rate than Hispanics. Black children had highest rates of choking fatalities over Hispanic, White, Asian, and Alaskan or American Indian ethnicities. The lowest rates of death occurred in Asians. CONCLUSIONS Overall rate of nonfatal choking injuries increased, while rate of choking fatalities in children decreased after 2010. However, the choking fatalities rate in 0-4 years olds, the highest risk group, did not change. Racial gaps exist with highest rates of injury in Black children. We must continue to educate and raise awareness of choking injuries, with targeted efforts to address racial disparities.
Collapse
Affiliation(s)
- David T Chang
- Division of Otolaryngology and Head and Neck Surgery, Children's Hospital of Orange County, Orange, CA, 92868, USA.
| | - Kaitlyn Abdo
- Chapman University, 1 University Dr., Orange, CA, 92866, USA
| | - Jay M Bhatt
- Division of Otolaryngology and Head and Neck Surgery, Children's Hospital of Orange County, Orange, CA, 92868, USA
| | - Kevin C Huoh
- Division of Otolaryngology and Head and Neck Surgery, Children's Hospital of Orange County, Orange, CA, 92868, USA
| | - Nguyen S Pham
- Division of Otolaryngology and Head and Neck Surgery, Children's Hospital of Orange County, Orange, CA, 92868, USA
| | - Gurpreet S Ahuja
- Division of Otolaryngology and Head and Neck Surgery, Children's Hospital of Orange County, Orange, CA, 92868, USA
| |
Collapse
|
10
|
Fola OK, Sango J, Ngatchou W. Eighteen years lasting bronchial foreign body: A case report in Cameroon, sub-Sahara Africa. Int J Surg Case Rep 2021; 79:281-285. [PMID: 33486310 PMCID: PMC7829115 DOI: 10.1016/j.ijscr.2020.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/06/2020] [Accepted: 12/10/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Foreign body aspiration represents an important cause of morbidity and mortality during childhood. A neglected aspirated foreign body can last for years, leading to complications that are sometimes difficult to manage, dramatically affecting the quality of life of the patient. CASE REPORT We report the case of a 29-year-old female who presented with eighteen-year history of recurrent cough, choking, and respiratory infections following a foreign body aspiration. The course was complicated by a chronic secondary lung abscess, successfully managed by combined medical and surgical treatment. DISCUSSION In low-income countries like ours, foreign body aspiration is often misdiagnosed. The often delayed management due to low socioeconomic status can lead to serious complications. To the best of our knowledge, it is the longest period of bronchial foreign body retention reported in the medical literature in Africa. CONCLUSION Foreign body aspiration is common in childhood and requires early recognition and treatment, in order to avoid complications that can be very serious or even fatal.
Collapse
Affiliation(s)
- Olivier Kopong Fola
- Department of Surgery, Douala General Hospital, Teaching Hospital, PO BOX 4856, Douala, Cameroon.
| | - Joseph Sango
- Department of Surgery, Douala General Hospital, Teaching Hospital, PO BOX 4856, Douala, Cameroon; Department of Surgery and Subspecialties, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
| | - William Ngatchou
- Department of Surgery, Douala General Hospital, Teaching Hospital, PO BOX 4856, Douala, Cameroon; Department of Surgery and Subspecialties, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
| |
Collapse
|
11
|
Risk Management and Recommendations for the Prevention of Fatal Foreign Body Aspiration: Four Cases Aged 1.5 to 3 Years and Mini-Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134700. [PMID: 32629891 PMCID: PMC7369691 DOI: 10.3390/ijerph17134700] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 12/19/2022]
Abstract
(1) Background: Foreign body aspiration (FBA) is a significant public health concern among the pediatric population, and fatalities are dramatic for families. It typically involves organic foreign bodies (mainly food) aspirated by children under three years old, usually at home or school. This review aimed to focus on the preventive measures around four actual cases of fatal foreign body aspiration, emphasizing the correct execution of the Heimlich maneuver and cardiopulmonary resuscitation, supervised mealtimes, and high-risk foods. (2) Methods: Four fatal cases of foreign body aspiration in children are presented here. The children were in a free environment, such as school, home, and the countryside, and were in the presence of teachers, parents, and a grandmother who did not supervise the children adequately. A literature review was performed via the MEDLINE database using the key terms: “foreign body aspiration,” “infant choking, 1.5 to 3 years,” “food and foreign body aspiration,” “common household,” “prevention of foreign body aspiration,” “guidelines,” “recommendations,” “training of caregivers (parents, educators),” “resuscitation,” “Heimlich maneuver,” and “disengagement of the upper airways.” We focused on the prevention of foreign body aspiration. (3) Results: a complete postmortem examination was performed. In three cases, the foreign bodies were food (mozzarella cheese, pear, or raw bean), while in one case, the foreign body was a pebble. (4) Conclusions: This review aimed to discuss recent scientific literature and provide a perspective on the benefits of a dedicated approach to the management of fatal foreign body aspiration in children by caregivers who usually have no experience with the best ways of supervising children in a safe environment, especially regarding the correct execution of resuscitation maneuvers, such as the Heimlich maneuver. Recommendation updates could improve healthcare quality in a pediatric setting and reduce medico-legal implications.
Collapse
|
12
|
Residual airway foreign bodies in children who underwent rigid bronchoscopy. Int J Pediatr Otorhinolaryngol 2019; 118:170-176. [PMID: 30639987 DOI: 10.1016/j.ijporl.2019.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 12/10/2018] [Accepted: 01/04/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To analyze the causes of residual airway foreign bodies in children who underwent rigid bronchoscopy in order to improve the success rate of primary surgery. METHODS Clinical data from 1130 children with airway foreign bodies, including 736 males and 394 females aged 0.42-14 years, who underwent rigid bronchoscopy in our hospital from January 2015 to May 2018 were retrospectively collected and analyzed by cluster sampling. Clinical characteristics including sex, age, time of onset, location of the foreign body, type of foreign body and experience of surgeon were gathered. All patients were classified into two groups as Group A (with residual airway foreign bodies) and Group B (without residual airway foreign bodies) according to chest CT scans and fiberoptic bronchoscope examinations after rigid bronchoscopy. The values were compared between the two groups. RESULTS Thirty-one patients with residual foreign bodies were confirmed by fiberoptic bronchoscopy among 1130 children with airway foreign bodies who underwent rigid bronchoscopy under general anesthesia. The percentage of residual airway foreign body was 2.7%. The mean age was 1.55 ± 0.46 years (range 1-3 years). There were 24 male patients (77.4%), and 7 female patients (22.6%), with a male/female ratio of 3.43:1. The time of onset was 1.0 (interquartile range: 1.0-8.0) day. There were no significant difference in age, sex and time of onset between the two groups. Most residual foreign bodies were food-related: nuts (n = 27, 87.1%), beans (n = 3, 9.7%), and one case was unclear in nature (3.2%). The residual incidence of fragile foreign bodies was higher than non-friable foreign bodies (P = 0.028). The most common residual foreign body locations were left superior lobar bronchi (32.3%), left inferior lobar bronchi (25.8%) and right inferior lobar bronchi (25.8%). The residual rate of foreign bodies for surgeons with more than 5 years of operative experience was 1.92%, and 4.25% for surgeons with less than 5 years of operation experience, showing a significant difference (P = 0.022). CONCLUSION Friable foods, the complicated structure of the bronchus tree and the surgeon's experience are important causes of residual foreign bodies in the airway. Surgeons with sufficient experience are important for the success of the procedure, which is supported by chest CT and flexible bronchoscopy.
Collapse
|
13
|
Abstract
Recognizing and acting early on airway compromise reduces morbidity and mortality in patients with airway obstruction. Causes include foreign bodies, toxic/hot fumes, difficult intubation, laryngeal spasm, and tumors. Before definitive control of the airway is possible, provide 100% oxygen with a tightly fitting mask to optimize body oxygen stores. Pulse oximetry is a poor indicator of airway compromise; a decreasing arterial hemoglobin oxygen saturation is a late sign of impending hypoxemia. Basic airway maneuvers improve the patency of an obstructed airway. Getting help from an anesthetist early is a priority.
Collapse
|