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

N. Kapur, A. Slater, J. McEniery, M. L. Greer, I. B. Masters, A. B. Chang

    Research output: Contribution to journalArticle

    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 brackishwaters andwas 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).

    Original languageEnglish
    Pages (from-to)1043-1047
    Number of pages5
    JournalPediatric Pulmonology
    Volume44
    Issue number10
    DOIs
    Publication statusPublished - 1 Oct 2009

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