[Risk factors of acute respiratory dysfunction in children with airway foreign body].

OBJECTIVE: This study aims to analyze the independent risk factors of acute respiratory dysfunction (ARD) in children with airway foreign body and to assess possible prevention and treatment option in the future.

METHODS: Clinical data of 456 cases of children with airway foreign body were retrospectively collected and analyzed by cluster sampling, including 246 males and 210 females, who received operation in our hospital between July, 2009 and December, 2012, aged 0.5-11 years old, onset to treatment time was 0.15-14 days. Clinical characteristics including age, gender, past medical history, time of onset, temperature, location of the foreign body, category of foreign bodies, complicated by pneumonia, complicated by subcutaneous and mediastinal emphysema were gathered. Temperature, respiratory rate, heart rate, cyanosis, transcutaneous oxygen saturation or arterial blood analysis were assayed before operation. Risk factors with statistical significance were screened with univariate logistic regression analysis, independent risk factors of ARD were determined with multivariate logistic regression analysis.

RESULTS: Acute respiratory dysfunction occurred in 78 (17.1%) patients. The foreign bodies in 455 cases were successfully removed brochoscopically in the first time. One case received chest surgery for foreign body removal. Total of 452 cases were successfully extubated and ventilator weaned 4-6 h after brochoscopy. In 2 cases, the ventilator was weaned 2-4 d after brochoscopy in ARD group, and 2 cases with severe pneumonia died. Age, location of the foreign body, temperature, complicated by pneumonia, complicated by subcutaneous and mediastinal emphysema did not show significant difference between acute respiratory dysfunction group and non- acute respiratory dysfunction group (P < 0.05). Multivariate logistic regression analysis showed location of the foreign body and complicated by pneumonia, complicated by subcutaneous and mediastinal emphysema were independent risk factors for ARD.

CONCLUSION: Early judgement of the risk factors of acute respiratory dysfunction in children with airway foreign body can provide a reference for the operation and perioperation period treatment.