Artigo Original/Original Article
Corpos estranhos na via aérea: Experiência de um quarto de século
Foreign bodies in the airway: A quarter of a century’s experience
1 Serviço de Medicina Interna Complementar de Pediatria, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Resident, specialist training in Paediatrics, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra
2 Assistente Hospitalar. Chefe de Serviço de Pneumologia, Serviço de Pneumologia, Hospital Geral, Centro Hospitalar de Coimbra / Head, Pulmonology Service, Pulmonology Unit, Hospital Geral, Centro Hospitalar de Coimbra
3 Directora do Serviço de Medicina. Chefe de Serviço de Pediatria, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Head, Paediatrics Unit, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra
4 Assistente Graduado Hospitalar de Pediatria, Serviço de Medicina, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Paediatrics Consultant and Specialist, Serviço de Medicina, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra
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Helena" "apellidos" => "Estêvão" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "af0015" ] ] ] 4 => array:3 [ "nombre" => "Miguel" "apellidos" => "Félix" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "af0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Serviço de Medicina Interna Complementar de Pediatria, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Resident, specialist training in Paediatrics, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar. Chefe de Serviço de Pneumologia, Serviço de Pneumologia, Hospital Geral, Centro Hospitalar de Coimbra / Head, Pulmonology Service, Pulmonology Unit, Hospital Geral, Centro Hospitalar de Coimbra" "etiqueta" => "2" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Directora do Serviço de Medicina. Chefe de Serviço de Pediatria, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Head, Paediatrics Unit, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra" "etiqueta" => "3" "identificador" => "af0015" ] 3 => array:3 [ "entidad" => "Assistente Graduado Hospitalar de Pediatria, Serviço de Medicina, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Paediatrics Consultant and Specialist, Serviço de Medicina, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra" "etiqueta" => "4" "identificador" => "af0020" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Foreign bodies in the airway: A quarter of a century’s experience" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-06-18" "fechaAceptado" => "2008-08-01" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570061" "palabras" => array:5 [ 0 => "Corpo estranho" 1 => "aspiração" 2 => "pediatria" 3 => "broncoscopia" 4 => "vias aéreas" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570060" "palabras" => array:5 [ 0 => "Foreign body" 1 => "aspiration" 2 => "paediatrics" 3 => "bronchoscopy" 4 => "airway" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdução</span>: A aspiração de corpos estranhos (CE) em idade pediátrica é uma situação comum e potencialmente grave, que pode estar associada a morbilidade significativa.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Objectivos:</span> Descrever as características dos casos de aspiração de CE para a via aérea, em crianças, no Hospital Pediátrico de Coimbra, num período de 25 anos.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Material e métodos:</span> Análise retrospectiva dos processos clínicos das crianças com o diagnóstico de aspiração de CE, durante o período de Janeiro de 1982 a Dezembro de 2006.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Resultados:</span> O diagnóstico de aspiração de CE foi confirmado em 316 crianças, com uma maior incidência nos primeiros 12 anos do período de estudo (64%). Cerca de 2/3 das crianças eram do sexo masculino (206), com idades compreendidas entre os 6 meses e os 12 anos. A maioria (83%) tinha idade inferior a 3 anos. Em 88% dos casos havia história de engasgamento, tendo o diagnóstico sido realizado precocemente (< 24<span class="elsevierStyleHsp" style=""></span>h) em 39%. Os sinais e sintomas mais frequentemente encontrados foram: assimetria do murmúrio vesicular e tosse. Constatou-se ausência de sintomas em 7% dos casos. A alteração radiológica encontrada mais frequentemente foi hiperinsuflação localizada (41%); em 22% não foi descrita alteração da radiografia de tórax. O tratamento foi efectuado exclusivamente por broncoscopia rígida. Foram descritos 22 casos de complicações da extracção. Os CE encontrados foram, predominantemente, de origem vegetal (75%). A localização preferencial dos CE foi à direita. Foi realizada broncofibroscopia (BF) de revisão em 116 casos.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusão:</span> Um episódio de aspiração de CE, despercebido e/ou subestimado, bem como a ausência inicial de sintomas e/ou a sua inespecificidade podem contribuir para um diagnóstico tardio. Houve uma notória redução dos casos de aspiração de CE na segunda metade da série, que poderá constituir um reflexo das estratégias de prevenção.</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (6): 787-802</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introduction</span>: Foreign body (FB) aspiration in children is a common and potentially dangerous situation that can be associated to significant morbidity.</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Aims:</span> To characterise the FB aspiration in children cases at the Hospital Pediátrico de Coimbra over a twenty five year period.</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Study design</span>: This study was based on the retrospective analysis of all clinical files of children who were diagnosed with foreign body aspiration January 1982 to December 2006.</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results:</span> Foreign body aspiration was confirmed in 316 children. The incidence was higher during the first twelve years of the study (64%). Around two thirds of the children were male (206) and the sample was aged 6 months to 12 years. Most children were younger than 3 years old (83%). In 88% of cases a choking episode was noticed while an early diagnosis (<<span class="elsevierStyleHsp" style=""></span>24<span class="elsevierStyleHsp" style=""></span>h) was obtained in only 39%. The most frequently described signs and symptoms were unilateral diminished breath sounds and cough. In 7% of cases no symptoms were described. The most frequently recorded radiology finding was focal hyperinflation (42%) and in 22% the chest x-ray was unremarkable. Treatment was exclusively by rigid bronchoscopy. Complications related to the bronchoscopy removal were described in 22 cases. Most aspirated FB were of vegetable origin (75%). The majority of FB was lodged in the right bronchial tree. Postremoval flexible bronchoscopy was performed in 116 cases.</p><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusion:</span> An unnoticed FB aspiration and absence of and/or non-specific initial symptoms may contribute to a late diagnosis. The significant reduction in the number of cases over the later years may be related to the implementation of preventive strategies.</p><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (6): 787-802</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia / Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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"referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Foreign body aspiration: a four-years experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Erikci" 1 => "S. Karacay" 2 => "A. Arikan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ulus Trauma Derg" "fecha" => "2003" "volumen" => "9" "numero" => "1" "paginaInicial" => "45" "paginaFinal" => "49" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bb0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Foreign body in the tracheobronchial tree" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.J.M. Cataneo" 1 => "S.M. Reibscheid" 2 => "R.P. 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"referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tracheobronchial foreign bodies: presentation and management in children and adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Baharloo" 1 => "F. Veyckemans" 2 => "C. Francis" 3 => "M.P. Biettlot" 4 => "D. Rodenstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1999" "volumen" => "115" "paginaInicial" => "1357" "paginaFinal" => "1362" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10334153" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bb0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tracheobronchial foreign body aspiration: a continuing challenge" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Soyal" 1 => "A. 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Rieger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpedsurg.2006.06.016" "Revista" => array:6 [ "tituloSerie" => "Journal of Pediatric Surgery" "fecha" => "2006" "volumen" => "41" "paginaInicial" => "1882" "paginaFinal" => "1888" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17101364" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bb0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Indications for flexible versus rigid bronchoscopy in children with suspected foreign body aspiration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:8 [ 0 => "A. Martinot" 1 => "M. Closset" 2 => "C.H. Marquette" 3 => "V. Hue" 4 => "A. Deschildre" 5 => "P. Ramon" 6 => "J. Remy" 7 => "F. 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Article information
ISSN: 08732159Original language: Portuguese
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