Turkish Archives of Pediatrics, published by Galenos Publishing Rigid bronchoscopies in pediatric patients with tracheobronchial foreign bodies: Our outcomes Address for Correspondence: Ayşe Çiğdem Tütüncü MD, İstanbul University, Cerrahpaşa Medical Faculty, Department of Anesthesiology and Reanimation, İstanbul, Turkey Phone: +90 212 414 300/225 74 Fax: +90 212 414 32 69 E-mail: acyardimci@yahoo.com Received: 10.05.2011 Accepted: 10.25.2011 Original Article Summary Aim: Tracheal or bronchial foreign body aspiration is a life-threatening emergency in children requiring immediate bronchoscopy under general anesthesia. The aim of this retrospective study was to evaluate the anesthetic management, hazards and complications of bronchoscopies performed because of suspicion of foreign body aspiration. Material and Method: We retrospectively analyzed the history, clinical and radiological findings and complications of 401 children admitted to the pediatric surgery department due to suspicion of foreign body aspiration between January 2006 and June 2011. Children requiring diagnostic bronchoscopies were excluded. All brochoscopies were performed under general anesthesia. Inhalation or IV induction and maintenance, spontaneous or controlled mechanical ventilation were selected individually according to the circumstances. Clinical findings, physical examination, radiological findings, anesthesia methods and complications of the patients were evaluated. Results: Cough (82%) and dyspnea (21.8%) were common symptoms of tracheobronchial foreign bodies. Most common radiological findings included air trapping (57%) and normal chest radiographs (21%). The aspirated foreign bodies were generally organic materials (80%) such as nuts, peanuts and seeds. The majority of foreign bodies lodged in the bronchial tree and the incidence of right sided (49.1%) foreign bodies was higher than that of the left sided (24.4%). Major complications during the anesthesia and postoperative period were desaturation, arrhythmia, hypercarbia and bronchospasm. Conclusions: Many problems can be experienced in children with inhaled foreign bodies. Bronchoscopy must be performed under optimal conditions in these patients. (Turk Arch Ped 2012; 47: 126-30) Key words: Foreign body, aspiration, bronchoscopy, anesthesia, pediatric DOI: 10.4274/tpa.1622 Ayşe Çiğdem Tütüncü, Özlem Korkmaz Dilmen, Rahşan Özcan*, Şenol Emre*, Güniz Köksal, Fatiş Altıntaş, Güner Kaya İstanbul University, Cerrahpaşa Medical Faculty, Department of Anesthesiology and Reanimation, İstanbul, Turkey *İstanbul University, Cerrahpaşa Medical Faculty, Department of Pediatric Surgery, İstanbul, Turkey 126 Introduction Tracheobronchial foreign body aspiration is an important urgency which can lead to death in the childhood. Rapid diagnosis and bronchoscopy performed afterwards can be lifesaving. Patients who have undergone bronchoscopy are in a high-risk group, since the intervention is always urgent and carries a risk of severe complications and the procedure includes serious problems (1). Common use of the airway, hyperactive airway, hemodynamic disorder which can occur during the procedure, affection of ventilation and oxygenation during the intervention, decrease in PaO2, increase in PaCO2, increase in airway resistance, decrease in FEV1 (forced expiratory volume in one second) and FVC (forced vital capacity) and a patient who is not fully prepared, who has respiratory stress or whose adequate fasting time has not passed mean a high complication rate and increase the difficulty of the procedure (2,3). In this retrospective study, children in whom foreign body extraction was performed by bronchoscopy were evaluated in terms of age, gender, clinical status, physical examination, radiologic findings and complications observed during and after the procedure. Material and Method In this study, patients in whom rigid bronchoscopy was performed because of foreign body aspiration in night and daytime conditions in Cerrahpaşa Medical Faculty Pediatric Surgery Operation Room between January 2006 and June