Spectrum, Prognostic Factors and Outcome of Commonly Missed Cause of Respiratory Distress in Children

Objectives Foreign body aspiration (FBA) is one of the important causes of respiratory distress, often missed. Early diagnosis and treatment prevent serious complications and improve the outcome. Our objective is to study the clinical profile, prognostic factors, and outcome of FBA in children. Material and Methods A prospective study was done from January 2019 to June 2023 in the Department of Paediatrics, Tertiary Care Centre, Tamil Nadu. Children aged 1 month–12 years presented with a history of FBA, and children brought with respiratory distress whose clinical-radiological findings favour FBA were included. Foreign body (FB) in the ear, nose, and gastrointestinal tract was excluded. Children’s age, sex, severity of hypoxia on arrival, duration between aspiration and diagnosis, duration of bronchoscopy procedure, site and nature of FB, pneumonia, and atelectasis in chest X-ray were the factors taken for analysis and outcome.Chi-square test and multiple logistic regression analysis were used for analysis. Results Totally 125 children were admitted with features of FBA. 32%, 52%, and 16% were in the age group of <1 year, 1–3 years, and >3 years respectively. 76% of children brought without a history of FBA came with complaints such as respiratory distress, recurrent respiratory tract infection, and wheezing. Decreased air entry on the one side of the chest was seen in 84% of children and chest X-ray showed same-side hyper-inflation in 72% of children. Computed tomography localized the FB in all cases. After a multiple logistic regression analysis, duration between Foreign body aspiration and diagnosis interval [odds ratio (OR) = 6.62, confidence interval (CI) = 1.22–35.8], duration of bronchoscopy procedure (OR = 3.6, CI = 1.65–7.89), pneumonia and atelectasis in chest X-ray (OR = 5.01, CI = 1.69–14.86) were associated with bad outcome. Conclusion A child presents with decreased air entry on one side of the chest and same side chest X ray showed hyperinflation, a FBA in the same main bronchus is the strong possibility. Early diagnosis and removal of FB yield excellent outcomes.