الفهرس 
Risk Factors Of Preoperative Respiratory Complications And Prolonged Pulmonary Recovery In Children With Tracheobronchial Foreign Bodies
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Abstract
Aspiration of foreign bodies into the tracheobronchial tree in children is a vital public health issue, and can be fatal.
Aim: To identify risk factors for preoperative respiratory complications associated with foreign body aspiration by analyzing pediatric cases presenting with or without complications.
Methods: Patients fulfilling the inclusion criteria were evaluated clinico-radiologically to detect respiratory complication prior to intervention of bronchoscopy. Patients were divided into two groups according to presence of preoperative abnormal radiological findings such as emphysema, consolidation, atelectasis or pneumothorax in imaging study (CXR or CT). Presence of preoperative abnormal radiological finding were classified as group A while absence of preoperative abnormal radiological finding were classified as group B. Age, sex, symptoms, type of foreign body, retention time and location of the foreign body were documented and compared between the groups.
Results: 106 children were included: group A (n=53) included those with abnormal imaging findings; group B (n=53) included those without abnormal imaging findings. Most common age of presentation was below three years. Females were involved in more than half of all cases (52.8%). The most common presentation after aspiration was cough. Emphysema and pneumonia were the most common complications, accounting for 71,7% and 15.1% of group A respectively. Twenty-two of different types fb were removed from the airways but the most common type was seed by 49% of all cases followed by nut (26. 4%).FB type was divided into organic and inorganic type. Cases (<1-year-old) are more susceptible to aspirate in organic FB than inorganic FB. Most of cases who aspirated in inorganic FB were in group B rather than group A. The right bronchus was the commonest site of FB impaction among group A(n=35) while in group B was the trachea (n=25). Airway granuloma found in group A with statistically significant difference in comparison to group B (p=0.04). There was increasing time of hospitalization in related to dyspnea(p=0.003), cases with lung collapse (p=0.008) and Cases aspirated in foreign body size more than 2cm admitted longer than others (p=0.006). Increasing duration of residency of FB associated with increase rate of airway complications as airway granuloma (p=0.011).
Conclusion: Children below 4 years are most susceptible to foreign body aspiration especially organic type. There was increasing the total hospital stay in related to respiratory complications. Delayed treatment placed our patients at a significant higher risk of developing airway complications.