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

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

Iran J Otorhinolaryngol. 2017 Nov;29(95):333-340

Authors: Mashhadi L, Sabzevari A, Gharavi Fard M, Shojaeian R, Salehi M, Joodi M, Fathi M, Jafarzadeh Esfehani A, Khazaeni K

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<0.001).
Conclusion: Controlled ventilation has the potential to be used as an effective alternative option in anesthesia for patients with suspected foreign body aspiration.

PMID: 29383314 [PubMed]

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