the foreign body deeper into the respiratory tree
during controlled ventilation.
The qualitative data such as sex, number of
patients with intraoperative changes in heart rate
and blood pressure, number of episodes of desatu-
ration and incidence of complications in both groups
were compared using chi-square test or Fisher’s
exact test where appropriate. The quantitative data
such as age, weight, severity score of desaturation,
ABG results and induction and recovery times were
compared using the Students t-test after determining
the normal distribution of the data. The values were
represented as mean ± SD. The results were consid-
ered significant if P-value was less than 0.05.
Results
The age, weight and sex distribution in the two
groups were comparable. The foreign bodies were
mostly organic in nature with history of aspiration
varying from 1 day to 2 months. The location of the
foreign bodies was in either of the bronchi, or both
the bronchi or bronchi as well as trachea (Table 1).
There was no statistically significant difference in
the number of patients with change in heart rate,
systolic blood pressure and diastolic blood pressure
in the two groups.
There were a total of 26 episodes of desaturation
in 17 patients in group I and 21 episodes of
desaturation in 19 patients in group II, giving a
value of 1.5 and 1.1 episodes of desaturation per
patient in groups I and II, respectively. The break
down of the number of episodes of desaturation
according to severity is given in Table 2. The means
of severity scores in groups I and II were 1.5 and 1.1,
respectively. The number of episodes of desatura-
tion and the severity scores were comparable in both
the groups. The episodes of desaturation in the
spontaneous ventilation group were clinically asso-
ciated with hypoventilation, breath holding or apnea
whereas those in the controlled ventilation group
were clinically associated with inability to ventilate
because of gross leak at the proximal end and/or
apnea when the surgeon was trying to remove or
localize the foreign body in the airway.
All the patients breathing spontaneously had to be
assisted to maintain adequate oxygen saturation.
Two patients in the spontaneous ventilation group
(group II) remained desaturated even after con-
trolled ventilation throughout the procedure until
the foreign body was removed from the airway. In
these two patients, the respiration had to be assisted
for a major duration of the procedure and later
controlled. If we exclude these two patients from the
spontaneous respiration group (group II), then the
means of percentage time of procedure during which
the patients remained desaturated in both groups
were 3.5 ± 4.7% for group I and 5.2 ± 6.6% for group
II. There was no statistically significant difference.
The complications seen in our study were intra-
operative
bucking
and
coughing,
ventricular
arrhythmia, laryngospasm, convulsion and post-
operative laryngeal edema and severe cough
(Table 3). Incidence of intraoperative coughing
and bucking in spontaneous group was statis-
tically highly significant (P ¼ 0.0012). All other
complications were equally distributed between the
two groups. There was no clinical evidence of
pushing the foreign body deeper into the respiratory
Table 1
Removed foreign bodies
Foreign body
Number of patients
Group I
Group II
Type
Organic
27
13
12
Inorganic
5
1
4
Location
Right bronchus
16
7
9
Left bronchus
8
5
3
Trachea
4
1
3
Multiple sites
4
1
9
Duration
<3 Days
13
4
9
>3 Days
23
13
10
Table showing the nature (organic or inorganic) and location of
the foreign bodies removed and the duration of time for which
these foreign bodies were in the respiratory tract in both groups.
Table 2
Severity of desaturation
Severity score
Group I
Group II
1 (Mild)*
11
10
2 (Moderate)**
5
3
3 (Severe)***
10
8
Table showing the number of patients with mild, moderate and
severe desaturations in each group.
*Severity score 1 (mild desaturation): SpO
2
80–90%.
**Severity score 2 (moderate desaturation): SpO
2
70–80%.
***Severity score 3 (severe desaturation): SpO
2
< 70%.
I N H A L E D F O R E I G N B O D I E S IN CH IL D R E N
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Ó 2004 Blackwell Publishing Ltd, Pediatric Anesthesia, 14, 947–952