Adult bronchial foreign body removal using prone position ventilation strategy:a case report

Bai Yang; Chen Dexiu

doi:10.3969/j.issn.1674-7151.2025.01.018

Abstract：Objective To report one case of using prone position simultaneous strategy to remove adult bronchial foreign body,and explore the potential use of prone ventilation in the treatment of bronchial foreign body in adults,especially in cases where fiberoptic bronchoscopy is difficult to remove the foreign body and the patient is in serious condition.Methods A 70-year-old male patient was admitted to Affiliated Hospital of Southwest Medical University on June 18th,2022.Due to a car accident,his tooth was sucked into the posterior basal segment of lower lobe in right lung,and he also suffered from closed traumatic brain injury(severe),hemorrhagic shock,lung contusion,left hemopneumothorax,right pneumothorax and lactic acidosis.After admission,the patient's oxygenation index gradually decreased and developed various serious complications such as acute respiratory distress syndrome(ARDS).Due to the difficulty of removing bronchial foreign body using fiberoptic bronchoscopy and the complexity of the patient's condition,a multidisciplinary consultation decided to prioritize the treatment of ARDS and other more serious complications.After the patient developed refractory hypoxemia,prone position ventilation therapy was used.Results After 14 hours of prone position ventilation treatment,the patient's tooth in bronchials was automatically dislodged without any adverse effects.Meanwhile,the patient's oxygenation was significantly improved.Conclusions Prone position ventilation is safe and effective in expelling bronchial foreign bodies.Therefore,the prone position ventilation strategy could be considered for critically ill patients with non-life-threatening bronchial foreign body and for patients who have difficulty in removing foreign body with fiberoptic bronchoscopy,which provides new ideas and approaches for clinical management.