Treatment of bronchial foreign body aspiration with extracorporeal life support in a child: A case report and literature review.
We present a case in which extracorporeal life support treatment of a 6-year-old girl asphyxiated by aspiration of an elliptic plastic ball is described. The attempts for extraction of the foreign body by conventional bronchoscopy under critically ill conditions had failed. Thus, a skin incision was made in the midline, and an emergency open-chest cardiopulmonary bypass (CPB) with aortic, superior vena cava and inferior vena cava cannulation was performed for circulatory support. Following tracheal extubation, a video-assisted rigid bronchoscope was inserted to clear the airway and remove the foreign body. The CPB lasted for 68 min, and the endotracheal tube was pulled out 6 h after the surgery. On the 10th day, the patient was discharged and followed up for 3 months when no neurological symptoms or other complications were documented. The removal of the aspirated bronchial foreign body under extracorporeal life support has been rarely reported. Here, we review the indication, cannulation method, support mode, surgical procedure, and patient outcome in the 8 papers retrieved from the PubMed database and compare their clinical characteristics with those of our case to justify the safe and effective use of CPB for critically ill patients with bronchial foreign body aspiration.
Department of Cardiac Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150006, China.
Li
L
Deng
Department of Cardiac Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150006, China.
Baichun
B
Wang
Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150006, China.
Yan
Y
Wang
Department of Otolaryngology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150006, China.
Lifeng
L
Xiao
Department of Cardiac Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150006, China. Electronic address: hyliu1963@163.com.
Hongyu
H
Liu
D060666:Airway Extubation; D001237:Asphyxia / Q000209:etiology / Q000628:therapy*; D001980:Bronchi; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000601:surgery*; D006801:Humans; D007442:Intubation, Intratracheal; D053120:Respiratory Aspiration; D014132:Trachea
Asphyxia; Bronchial foreign body aspiration; Cardiopulmonary bypass; Extracorporeal membrane oxygenation