A Retrospective Study on Fetomaternal Outcome in Gestational Diabetes Mellitus in Tertiary Care Hospital – Case Report

Abstract Introduction: Foreign body removal from airway in paediatric age group is challenging. As airway manipulation during spontaneous breathing can lead to complications like aspiration, bronchospasm, laryngospasm, difficult access due to vocal cord movements and securing airway with endotracheal tube/tracheostomy tube led to displacement of foreign body. Objectives: Prevent hypoxia with few complications and maximum surgeon comfort during FB removal from airway. Methods: A 13-year-old male child was partially operated for foreign body removal at private hospital, then patient was referred to TBCD department, New civil hospital for the same. On admission CT thorax was done which showed a 16*8 mm oval shaped hyperdense lesion with underlying collapsed right lung. Under ASA Class 4E sos post operative ventilatory support child was shifted to OT with SpO2 86%, respiratory rate 40-44/min, pulse 118/min & air entry was present only on left side of lungs. Preoxygenation was done with HFNO with O2 @ 15L/min and patient induced with Inj. Ketamine 30 mg, Inj. Propofol 30 mg Inj. Scoline 30 mg iv & rigid bronchoscopy started. During procedure patient was maintained on intermittent ketofol [1:1] & intermittent scoline with HFNO 50L/min & nasal EtCO2, SpO2, ECG was monitored. As foreign body was a seed and broken into pieces, 50-60 min was taken to complete the procedure. Whole procedure completed with HFNO without single time bag and mask ventilation. Conclusion: A novel device, HFNO [O2 @50L/Min] can be used safely for foreign body removal to facilitate un-interrupted bronchoscopy procedure.