Pediatric anesthetic for tracheobronchial foreign body extraction: A survey of practice in France

Background: Tracheobronchial foreign body aspiration is a classic pediatric emergency, and its associated morbidity particularly depends on the anesthetic management, which differs according to the center and the practitioner. Aims: The aim of this study was to evaluate the different anesthetic practices for tracheobronchial foreign body extraction. Methods: A survey was sent via email to the member physicians of the Association des Anesthesistes Reanimateurs Pediatriques d'Expression Francaise (ADARPEF). The survey included 28 questions about the organizational and anesthetic management of an evolving clinical case. Results: A total of 151 physicians responded to the survey. Only 13.2% of the respondents reported that their institution had a management protocol, and 21.7% required a computerized tomography scan before the procedure was performed for children who were asymptomatic or mildly symptomatic during the night. There were 56.3% of the respondents who reported that extraction with a rigid bronchoscope is the only procedure usually performed in their institution. Regarding rigid bronchoscopy, 47.0% used combined intravenous-inhalation anesthesia. The objective was to maintain the child on spontaneous ventilation for 63.6% of the respondents, but anesthesia management differed according to the physician's experience. Conclusions: Our study confirms the diversity of practices concerning anesthetic for tracheobronchial foreign body extraction and found reveal differences in practice according to physician experience.