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

Kapur, Nitin, Slater, A., McEniery, J., Greer, M. L., Masters, Ian B. and Chang, Anne 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.

Document type: Journal Article
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Title Therapeutic bronchoscopy in a child with sand aspiration and respiratory failure from near drowning - case report and literature review
Author Kapur, Nitin
Slater, A.
McEniery, J.
Greer, M. L.
Masters, Ian B.
Chang, Anne B.
Journal Name Pediatric Pulmonology
Publication Date 2009
Volume Number 44
Issue Number 10
ISSN 1099-0496   (check CDU catalogue  open catalogue search in new window)
Start Page 1043
End Page 1047
Total Pages 5
Place of Publication US
Publisher John Wiley & Sons
HERDC Category C2 - Journal Article - Other contributions to refereed journal (internal)
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).
Keywords aspiration
sand
near drowning
bronchoscopy
surfactant
DOI http://dx.doi.org/10.1002/ppul.21088   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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