Department of Pediatric Anesthesia and Intensive Care, CHU Timone, Marseille, France.
Assistance-Publique - Hôpitaux de Marseille, Marseille, France.
Paediatr Anaesth. 2023 Sep;33(9):736-745. doi: 10.1111/pan.14704. Epub 2023 Jun 10.
Tracheobronchial foreign body aspiration is a classic pediatric emergency, and its associated morbidity particularly depends on the anesthetic management, which differs according to the center and the practitioner.
The aim of this study was to evaluate the different anesthetic practices for tracheobronchial foreign body extraction.
A survey was sent via email to the member physicians of the Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF). The survey included 28 questions about the organizational and anesthetic management of an evolving clinical case.
A total of 151 physicians responded to the survey. Only 13.2% of the respondents reported that their institution had a management protocol, and 21.7% required a computerized tomography scan before the procedure was performed for children who were asymptomatic or mildly symptomatic during the night. There were 56.3% of the respondents who reported that extraction with a rigid bronchoscope is the only procedure usually performed in their institution. Regarding rigid bronchoscopy, 47.0% used combined intravenous-inhalation anesthesia. The objective was to maintain the child on spontaneous ventilation for 63.6% of the respondents, but anesthesia management differed according to the physician's experience.
Our study confirms the diversity of practices concerning anesthetic for tracheobronchial foreign body extraction and found reveal differences in practice according to physician experience.
气管支气管异物吸入是一种经典的儿科急症，其相关发病率尤其取决于麻醉管理，而麻醉管理因中心和从业者的不同而有所差异。
本研究旨在评估气管支气管异物取出术的不同麻醉实践。
通过电子邮件向法语表达儿科麻醉和复苏医师协会（ADARPEF）的成员医师发送了一份调查问卷。该调查问卷包括 28 个问题，涉及不断变化的临床病例的组织和麻醉管理。
共有 151 名医师对该调查做出了回应。只有 13.2%的受访者表示他们的机构有管理方案，而 21.7%的受访者要求在夜间无症状或症状轻微的儿童进行该手术前进行计算机断层扫描。56.3%的受访者报告说，他们的机构通常只进行硬性支气管镜检查。对于硬性支气管镜检查，47.0%的人使用静脉-吸入联合麻醉。47.0%的受访者的目标是使儿童保持自主呼吸，但麻醉管理因医师的经验而异。
我们的研究证实了气管支气管异物取出术麻醉实践的多样性，并发现实践因医师经验而异。
