Department of Otorhinolaryngology, Bhumibol Adulyadej Hospital, Bangkok, Thailand.
Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand.
Auris Nasus Larynx. 2023 Aug;50(4):607-613. doi: 10.1016/j.anl.2022.10.003. Epub 2022 Oct 26.
Pediatric respiratory emergencies of airway foreign body (FB) are a common cause of visits to the emergency department (ED) and respiratory failure is a major cause of cardiopulmonary arrest. The purpose of this study is to evaluate the literature and update our current understanding of pediatric respiratory tract FBs in children by clearly considering the aspect of the complications and related factors.
A systematic search of PubMed and Embase yielded a total of 2035 studies related to the respiratory tract FB in children. After screening the abstracts, 118 articles were included for analysis. However, 56 articles were excluded due to the published data more than 10 years. Meanwhile, 6 articles were duplicated and 3 articles were the secondary data. Thus, 53 full text articles were assessed for eligibility. Then, 46 full text articles were excluded due to irrelevant contents. Finally, there were 7 qualitative articles in this systematic review.
Most children with FBs in the aerodigestive tract are 1-3 years of age. Most FBs are organic, especially seeds. The most commonly obstructed airway is the right primary bronchus. The most common and severe complications are pneumonia, pulmonary atelectasis, lung consolidation, pneumothorax, bronchiectasis, and death. The main device for the removal of FBs from the airways is a rigid bronchoscope. Duration of diagnosis is major factors that related with severe complication.
FBs obstructive conditions in respiratory tract of children are serious and life-threatening conditions. The likelihood of death depends on the location of the obstruction, the nature of FB, time to removal, and initial resuscitation. Moreover, even after a FB has been removed, complications can lead to death. Educating parents and immediate treatment is very important. Rapid diagnosis is important factor to prevent complication.
小儿气道异物（FB）是儿科急诊常见的呼吸道急症，呼吸衰竭是心肺骤停的主要原因。本研究旨在通过明确考虑并发症及其相关因素，评估文献并更新目前对小儿呼吸道 FB 的认识。
对 PubMed 和 Embase 进行系统检索，共获得 2035 项与小儿呼吸道 FB 相关的研究。筛选摘要后，纳入 118 篇文章进行分析。然而，由于发表数据超过 10 年，有 56 篇文章被排除在外。同时，有 6 篇文章是重复的，3 篇文章是二次数据。因此，评估了 53 篇全文文章的合格性。然后，由于内容不相关，有 46 篇全文文章被排除在外。最后，该系统评价有 7 篇定性文章。
大多数气道异物的儿童年龄在 1-3 岁。大多数 FB 是有机的，尤其是种子。最常阻塞的气道是右主支气管。最常见和最严重的并发症是肺炎、肺不张、肺实变、气胸、支气管扩张和死亡。从气道取出 FB 的主要器械是硬性支气管镜。诊断时间是与严重并发症相关的主要因素。
儿童呼吸道 FB 阻塞情况严重，危及生命。死亡的可能性取决于阻塞的位置、FB 的性质、取出的时间和最初的复苏。此外，即使 FB 已经取出，并发症也可能导致死亡。教育家长和及时治疗非常重要。快速诊断是预防并发症的重要因素。
