Efficacy of manual jet ventilation using Manujet III for bronchoscopic airway foreign body removal in children.
OBJECTIVE
To evaluate the efficacy of a manual jet ventilation device for bronchoscopic removal of foreign bodies in children.


METHODS
360 children aged from 10 months to 12 years old undergoing rigid bronchoscopy for airway foreign body (FB) removal from February 2005 to June 2009 were included in the study. Patients were randomly divided into three groups of 120 patients per group (S, P and J). In group S, anesthesia was induced with propofol and γ-hydroxybutyrate sodium and maintained by intermittent bolus administration of propofol; the patients were breathing spontaneously throughout the procedure. In group P, anesthesia was induced with propofol (4-5 mg/kg), fentanyl (1-2 μg/kg) and succinylcholine (2 mg/kg). Mechanical ventilation was performed through the side arm of the rigid bronchoscope. In group J, the patient received propofol, fentanyl and succinylcholine as the same doses administered in group P, and manual jet ventilation was performed by using the Manujet III device. Condition for insertion of bronchoscope, occurrence of hypoxemia, successful rate of FB removal, the duration of the operation, the time of emergence and recovery from anesthesia, and perioperative complications (adverse events) were recorded.


RESULTS
Groups P and J had significantly higher rates of successful bronchoscope insertion (P<0.05), significantly higher success rates for FB removal (P<0.05), and lower incidences of hypoxemia during intra- and post-operative periods when compared with group S. Perioperative complications were lower (P<0.05), duration of operation was shorter, and emergence from anesthesia was faster (P<0.05) in groups P and J when compared with group S. Incidences of hypoxemia were lower in Group J when compared with Group P (P<0.05).


CONCLUSIONS
This study confirmed the safety and efficacy of performing manual jet ventilation with Manujet III in foreign body removal by rigid bronchoscopy in children.
Li
Shaoqing
S
Department of Anesthesiology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China.
Liu
Yuqi
Y
Tan
Fang
F
Chen
Junliang
J
Chen
Lianhua
L
D000758:Anesthesia; D018686:Anesthetics, Intravenous; D001980:Bronchi; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005283:Fentanyl; D005547:Foreign Bodies / Q000628:therapy*; D006611:High-Frequency Jet Ventilation; D006801:Humans; D006885:Hydroxybutyrates; D007223:Infant; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D009467:Neuromuscular Depolarizing Agents; D015742:Propofol; D013390:Succinylcholine; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D006885:Hydroxybutyrates; D009467:Neuromuscular Depolarizing Agents; C111420:4-hydroxybutyric acid; D013390:Succinylcholine; D005283:Fentanyl; D015742:Propofol