Özlem ÖZ GERGİN, Sibel Seçkin PEHLİVAN, Oğuz Kaan ŞİMŞEK, İbrahim ERKAN, Karamehmet YILDIZ, Mehmet KÖSE

GENEL ANESTEZİ ALTINDA FİBEROPTİK BRONKOSKOPİ YAPILAN PEDİATRİK VAKALARIN RETROSPEKTİF ANALİZİ: TEK MERKEZDE BEŞ YILLIK DENEYİM

Laringeal maske (LMA)’nin fleksibl fiber optic bronkoskopi (FFB) sırasında kullanımı diğer hava yolu araçlarıyla karşılaştırıldığında daha avantajlıdır. Bu çalışmada, çocuk hastalarda FFB’de hava yolu idamesi için LMA kullanımının uygulama başarı oranları ve karşılaşılan postoperative komplikasyonları hastaların demografik özellikleri, ASA risk grupları, anestezi süresi ve bronkoskopik tanıları ile değerlendirerek literature eşliğinde gözden geçirilmesi planlandı. Ocak 2017 -Ocak 2022 tarihleri arasında FFB yapılan çocuk hastaların dosyaları geriye dönük olarak incelendi. Hastaların demografik verileri, FFB’de hava yolu idamesi için kullanılan hava yolu gereci (LMA, endotrakealtüp, trakealtüp), bronkoskopi endikasyonları, bronkoskopik tanıları, anestezi süresi, işlem sonrası desaturasyon, laringo spazm, bronco spazm ve reentübasyon gereken hasta sayısı kaydedildi. Çalışmaya yaşları 0-17 arasında değişen 162 pediatrik hasta dahil edildi. Median yaş 6.9 (çeyrekler arası aralık 0-17 yaş) ve median ağırlık 24.5 kg (çeyrekler arası aralık 2.5-89) idi. Torasik BT anormallikleri olan ve tanıyı desteklemek için ameliyat gerektiren hasta grubu ensık görülen FOB endikasyonuydu (n=37, %22.8). Toplamda 28 hastada (%17.3) geçici hipoksi, 62 hastada (%38.3) bronco spazm görüldü. Pediatrik hastalarda LMA yoluyla FOB güvenli bir yöntemdir. Uygun ekipman, deneyimli personel, iyi hasta seçimi ve bronkoskopi sonrası hastanın yeterli sure izlemde tutulması komplikasyonların önlenmesinde ve azalmasında en önemli etkenler arasındadır.

Anahtar Kelimeler:

çocuk, fiberoptik bronkoskopi, laryngeal maske

A RETROSPECTIVE ANALYSIS OF PEDIATRIC CASES UNDERGOING FIBEROPTIC BRONCHOSCOPY UNDER GENERAL ANESTHESIA: A FIVE-YEAR EXPERIENCE AT A SINGLE CENTER

The use of the laryngeal mask (LMA) during flexible fiberoptic bronchoscopy (FOB) is more advantageous compared to other airway devices. In this study, the use of LMA for airway maintenance in FOB in pediatric patients was planned to be reviewed in the light of the literature by evaluating the postoperative complications encountered with the demographics of the patients, the duration of anesthesia, and bronchoscopic diagnoses. Between January 2017 and January 2022, the files of pediatric patients who underwent FOB were reviewed retrospectively. The patients' demographics, the airway device used for airway maintenance in FOB (LMA, endotracheal tube, tracheal tube), bronchoscopy indications, bronchoscopic diagnoses, duration of anesthesia, post-procedure hypoxia, laryngospasm, and the number of patients requiring bronchospasm were all recorded. The study included 162 pediatric patients ranging in age from 0 to 17. The median age was 6.9 years old (interquartile range 0-17 years old), and the median weight was 24.5 kg (interquartile range 2.5-89). The patient group having thoracic CT abnormalities and requiring an operation to support the diagnosis was the most prevalent FOB indication (n=37, 22.8%). In all, 28 patients (17.3%) experienced temporary hypoxia, whereas 62 patients (38.3%) experienced bronchospasm. In pediatric patients, FOB via LMA is a safe method. Appropriate equipment, experienced personnel, good patient selection, and adequate follow-up of the patient after bronchoscopy are among the most important factors in the prevention and reduction of complications.

Keywords:

child, fiberoptic bronchoscopy, laryngeal mask,

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