Retirada de corpo estranho em via aérea de crianças por broncoscopia flexível: revisão sistemática da literatura.

Abstract

Introduction: The airway obstruction by foreign bodies is an uncommon entity, but potentially fatal if not properly managed. It can present in various forms, as an acute respiratory failure or even chronic cough and recurrent pneumonia. The diagnostic and therapeutic management is done preferably with bronchoscopy, and the gold standard for treatment is rigid bronchoscopy. However, the routine use of flexible bronchoscopy, especially in children, is still a matter of debate Rationale: The literature does not have sufficient data to establish the safety of flexible bronchoscopy for removal of foreign bodies in pediatric patients’ airways. This study seeks to contribute to the formation of knowledge through systematic literature review. Objective: Make a systematic review to assess the outcomes of pediatric patients with airway obstruction by foreign bodies treated with fiberoptic bronchoscopy. Methodology: The search for articles was performed using the databases PubMed and Lilacs, based on descriptors: bronchoscopy; foreign bodies; airway obstruction. The search included articles in Portuguese, English and Spanish, published from 2005 to 2015. The folllowing types of studies were included: randomized clinical trial, Cross-sectional studies, longitudinal studies, cohort. Selected studies involving the following characteristics: "child", "infant", "child”, “preschool", "infant, “newborn"; who had flexible bronchoscopy as established therapy. Results: There were analyzed 12 articles that met the inclusion criteria, of which 04 were the subject of this study. It was found a higher prevalence in male patients, aged less than three years and mostly organic foreign bodies. The main obstruction site was the right main bronchus. Data were discordant of the therapeutic success, varying between 37% and 91.3 % of cases. There were no deaths in the analyzed series. Conclusion: Although discrepant data, the therapeutic efficacy of flexible bronchoscopy, can not be accurately measured, especially by the low level of scientific evidence of the articles found.