Therapeutic bronchoscopy in a child with sand aspiration and respiratory failure from near drowning-case report and literature review

Kapur, N., Slater, A., McEniery, J., Greer, M. L., Masters, I. B. and Chang, A.B. (2009) Therapeutic bronchoscopy in a child with sand aspiration and respiratory failure from near drowning-case report and literature review. Pediatric Pulmonology, 44 10: 1043-1047. doi:10.1002/ppul.21088


Author Kapur, N.
Slater, A.
McEniery, J.
Greer, M. L.
Masters, I. B.
Chang, A.B.
Title Therapeutic bronchoscopy in a child with sand aspiration and respiratory failure from near drowning-case report and literature review
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 8755-6863
1099-0496
Publication date 2009-09-10
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1002/ppul.21088
Open Access Status
Volume 44
Issue 10
Start page 1043
End page 1047
Total pages 5
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Subject 1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
9201 Clinical Health (Organs, Diseases and Abnormal Conditions)
Formatted abstract
Foreign matter aspiration occurs relatively commonly in drowning and near-drowning events. In most cases, stomach contents are aspirated. Sand aspiration rarely occurs and there are no reported cases in children with near drowning. Limited data are available on clinical presentation and management of sand aspiration with accidental burial. We report a 3-year-old boy who nearly drowned while swimming in brackish waters and was found face down in sand. Sand aspiration was suspected when the child continued to have persistent wheezing and high ventilatory requirement despite intensive bronchodilator and corticosteroids therapy with an inability to wean after 4 days post-near-drowning event. Radiology was non-specific in the absence of sand bronchogram. Presence of sand in the airways was confirmed when a bronchoscopy was undertaken and sand seen in the bronchoalveolar lavage fluid. Sequential lung washing followed by exogenous surfactant administration (3 ml/kg) was undertaken and lead to significant improvement such that within 12 hr post-therapeutic lavage, his ventilatory requirements reduced substantially. The child was extubated 4 days post-lavage and on review 2 months post-event, was clinically well with airway resistance within normal predicted values measured on forced oscillatory spirometry (IOS).
Keyword Aspiration
Surfactant
Bronchoscopy
Near drowning
Sand
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
 
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Created: Wed, 31 Mar 2010, 11:21:39 EST by Amanda Jones on behalf of Medical Imaging - RBWH