[Bronchoscopy in children with foreign body aspiration]. / Broncoscopia en población infantil tras aspiración de cuerpo extraño.

INTRODUCTION AND OBJECTIVES: Aspiration of foreign body presents a high incidence of mortality during the paediatric life period. Family suspect and detection of specific symptoms and signs determine the need of bronchoscopy. The objective of this study is to establish the clinical parameters that indicate foreign body in airway. METHODS: Retrospective study in 44 children with foreign body aspiration. We reviewed age, sex, family suspect, blood analysis, chest x-ray, time to consulting, location, type, complications, and time to discharge. RESULTS: Decisive clinical factors that indicate foreign body in airway are family suspect and respiratory clinic. Findings after auscultation and chest x-ray support suspect, but final diagnostic only can be made after bronchoscopy. Bronchoscopy with foreign body removal was performed during first 24 hours in 86.36 % of patients, and founded that those with delayed diagnosis had increased morbidity. CONCLUSIONS: Family's suspect is the most important parameter that indicates foreign body located in airway. Bronchoscopy performed during the first hours avoids morbidity. This is a secure technique when performed in adequate place with trained personnel.

Broncoscopia en población infantil tras aspiración de cuerpo extraño / Bronchoscopy in children with foreign body aspiration

Introducción y objetivos: La aspiración de cuerpos extraños supone en la edad pediátrica una importante causa de mortalidad. La sospecha familiar y la detección de síntomas y signos de riesgo determinan la necesidad de realizar una broncoscopia. El objetivo de este trabajo es determinar qué parámetros ofrecen más sensibilidad para detectar un cuerpo extraño obstructivo. Métodos: Estudio retrospectivo en 44 pacientes con sospecha de cuerpo extraño en la vía aérea. Se estudia la edad y el sexo, la sospecha familiar, la clínica, la analítica, la radiografía de tórax, el tiempo medio hasta la consulta hospitalaria, la localización del cuerpo extraño, el tipo de cuerpo extraño, las complicaciones y la estancia hospitalaria. Resultados: Los factores más determinantes que indican la presencia de un cuerpo extraño fueron la sospecha familiar y la clínica. Los hallazgos tras la auscultación y la radiografía de tórax dan apoyo a la sospecha, aunque el diagnóstico final sólo se establece tras la realización de la broncoscopia. Se realizó broncoscopia en las primeras 24 h, y se extrajo cuerpo extraño en el 86,36 % de los pacientes; en los casos en que se retrasó el diagnóstico hubo aumento de la morbilidad. Conclusiones: La sospecha clínica familiar inicial es el factor fundamental para llegar al diagnóstico. La realización de esta técnica en las primeras horas tras la sospecha evita morbilidad. La broncoscopia es una técnica segura siempre que sea realizada en un medio adecuado y por personal entrenado

Introduction and objectives: Aspiration of foreign body presents a high incidence of mortality during the paediatric life period. Family suspect and detection of specific symptoms and signs determine the need of bronchoscopy. The objective of this study is to establish the clinical parameters that indicate foreign body in airway. Methods: Retrospective study in 44 children with foreign body aspiration. We reviewed age, sex, family suspect, blood analysis, chest x-ray, time to consulting, location, type, complications, and time to discharge. Results: Decisive clinical factors that indicate foreign body in airway are family suspect and respiratory clinic. Findings after auscultation and chest x-ray support suspect, but final diagnostic only can be made after bronchoscopy. Bronchoscopy with foreign body removal was performed during first 24 hours in 86.36 % of patients, and founded that those with delayed diagnosis had increased morbidity. Conclusions: Family’s suspect is the most important parameter that indicates foreign body located in airway. Bronchoscopy performed during the first hours avoids morbidity. This is a secure technique when performed in adequate place with trained personnel