Risk factors associated with reintubations in children undergoing foreign body removal using flexible bronchoscopy: a single-center retrospective cross-sectional study

Su-Jing Zhang; Hong-Bin Gu; Min Zhou; Min-Yi Lin; Long-Xin Zhang; Xiu-Ying Chen; Guo-Lin Lu

doi:10.1186/s12871-022-01756-9

Risk factors associated with reintubations in children undergoing foreign body removal using flexible bronchoscopy: a single-center retrospective cross-sectional study

BMC Anesthesiol. 2022 Jul 13;22(1):219. doi: 10.1186/s12871-022-01756-9.

Authors

Su-Jing Zhang^#^{1

2

3}, Hong-Bin Gu^#^{2

4}, Min Zhou^#^{1

2

3}, Min-Yi Lin^{2

3}, Long-Xin Zhang^{1

3}, Xiu-Ying Chen^#^{1

3}, Guo-Lin Lu^#^{5

6

7}

Affiliations

¹ Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
² Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children's Hospital, Fuzhou, China.
³ Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China.
⁴ Department of anesthesia, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Shanghai, China.
⁵ Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China. guolinlu2020@fjmu.edu.cn.
⁶ Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children's Hospital, Fuzhou, China. guolinlu2020@fjmu.edu.cn.
⁷ Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China. guolinlu2020@fjmu.edu.cn.

^# Contributed equally.

Abstract

Background: Reintubation is a severe complication during foreign body (FB) removal that uses flexible bronchoscopy.

Objective: To investigate the incidence and risk factors for reintubations in children undergoing FB extraction by flexible bronchoscopy in a single center.

Design: A retrospective cross-sectional study.

Setting: All children with foreign body aspiration at Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University from January 2015 to December 2020.

Patients: Children with FB removal using a flexible bronchoscopy were enrolled in the trial according to the inclusion criteria.

Measurements: Both multivariable and logistic regression analyses were used to analyze the association between characteristic data and reintubations. The results were presented as odds ratios (ORs) with 95% confidence intervals (CIs).

Results: In total, 244 patients met with the inclusion criteria and were included in the analysis. Among those participants, 28 children (11.5%) underwent reintubations after FB removal by flexible bronchoscopy. Independent factors associated with reintubations were identified as operative time ≥ 60 min [OR: 3.68, 95% CI (1.64-8.82)] and ASA ≥ III [OR: 5.7, 95% CI (1.23-26.4)].

Conclusions: Children undergoing FB removal by a flexible bronchoscopy may encounter with a high incidence of postoperative reintubations. Both long operative duration and a severe physical status cause a growing risk of reintubations.

Keywords: Flexible bronchoscopy; Foreign body; Reintubation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bronchoscopy* / methods
Child
Cross-Sectional Studies
Female
Foreign Bodies* / epidemiology
Foreign Bodies* / surgery
Humans
Incidence
Infant
Pregnancy
Retrospective Studies
Risk Factors