{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T18:04:37Z","timestamp":1780682677731,"version":"3.54.1"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Anhui Province Clinical Medical Research and Translation Project","award":["202304295107020006"],"award-info":[{"award-number":["202304295107020006"]}]},{"name":"Anhui Province Clinical Medical Research and Translation Project","award":["202304295107020001"],"award-info":[{"award-number":["202304295107020001"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Airway foreign-body aspiration in adults is uncommon but can be life-threatening.Flexible bronchoscopy is the standard first-line therapy,but critically ill patients may need extracorporeal life support.This study aims to characterize the diagnosis,management,and outcomes of adult airway foreign-body cases treated at a single center over nearly 12 years to inform a standardized clinical pathway.A single-center retrospective observational study of consecutive patients aged \u226514 years with confirmed airway foreign body who were treated at a tertiary hospital in China were conducted.Medical records of consecutive adolescent and adult patients diagnosed with airway foreign-body aspiration and admitted to the hospital from 01\/01\/ 2014\u201330\/11\/2025 were reviewed.Data included demographics,imaging,extraction method, respiratory support and so on.Descriptive statistics were reported as medians with interquartile ranges or counts and percentages.A total of 41 patients were included,with a median age of 59.5 years(interquartile ranges 51\u201372) and 65.85% male.Flexible bronchoscopy was attempted as the primary intervention in 38 patients(92.68%) and succeeded in 81.58%(31\/38) to remove airway foreign body.Most patients(78.05%) required only nasal cannula oxygen,while nine patients(21.95%) needed advanced support including mechanical ventilation (14.63%),high-flow oxygen(4.88%),and extracorporeal life support (2.44%).At discharge,most survivors had a good neurological outcome,with 36 patients(87.80%) having a Cerebral Performance Categories score of 1.The 28-day survival rate was 92.68%.These findings show that flexible bronchoscopy is an effective first-line therapy,and rigid bronchoscopy or surgery is useful when flexible bronchoscopy fails.In unstable cases,timely extracorporeal life support can bridge to definitive removal.These results support a tiered,multidisciplinary approach incorporating early chest computed tomography,flexible bronchoscopy,and escalation to advanced airway or extracorporeal support.<\/jats:p>","DOI":"10.1371\/journal.pone.0351214","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:37:28Z","timestamp":1780681048000},"page":"e0351214","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and management strategies in adult foreign-body airway obstruction: A retrospective cohort study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2475-4718","authenticated-orcid":true,"given":"Hongzhen","family":"Yin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changshun","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingya","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaogan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiancheng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1776-7051","authenticated-orcid":true,"given":"Weihua","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"issue":"2","key":"pone.0351214.ref001","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jemermed.2022.12.008","article-title":"Evaluation and Management of Airway Foreign Bodies in the Emergency Department Setting","volume":"64","author":"JJ White","year":"2023","journal-title":"J Emerg Med"},{"issue":"52","key":"pone.0351214.ref002","article-title":"Risk factor analysis of bronchospasm after tracheobronchial foreign body removal: Cases report and literature review (STROBE)","volume":"99","author":"Y Cui","year":"2020","journal-title":"Medicine (Baltimore)"},{"issue":"12","key":"pone.0351214.ref003","article-title":"Navigating challenges in adult airway foreign body extraction: retrospective insights from flexible bronchoscopy","volume":"16","author":"RN Jalandra","year":"2024","journal-title":"Cureus"},{"issue":"2","key":"pone.0351214.ref004","doi-asserted-by":"crossref","DOI":"10.1097\/SCS.0000000000005660","article-title":"The Utility of Endoscope-Assisted Rigid Bronchoscopy in Pediatric Airway Foreign Body Removals","volume":"31","author":"S Ozdemir","year":"2020","journal-title":"J Craniofac Surg"},{"issue":"10","key":"pone.0351214.ref005","first-page":"1870","article-title":"Endoscopic intervention of lower airway foreign matter in adults-a different perspective","volume":"7","author":"AAL Hsu","year":"2015","journal-title":"J Thorac Dis"},{"issue":"11","key":"pone.0351214.ref006","doi-asserted-by":"crossref","first-page":"3452","DOI":"10.21037\/jtd.2016.11.32","article-title":"Update in the extraction of airway foreign bodies in adults","volume":"8","author":"M Blanco Ramos","year":"2016","journal-title":"J Thorac Dis"},{"issue":"6","key":"pone.0351214.ref007","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1053\/j.jvca.2020.07.035","article-title":"Use of Extracorporeal Membrane Oxygenation to Facilitate Removal of a Tracheal Foreign Body in an Adult","volume":"35","author":"KG Parr","year":"2021","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"3","key":"pone.0351214.ref008","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.jemermed.2013.03.017","article-title":"Extracorporeal membrane oxygenation can provide cardiopulmonary support during bronchoscopic clearance of airways after sand aspiration","volume":"45","author":"KB Metcalf","year":"2013","journal-title":"J Emerg Med"},{"key":"pone.0351214.ref009","doi-asserted-by":"crossref","first-page":"1189722","DOI":"10.3389\/fped.2023.1189722","article-title":"Case report: Foreign body aspiration requiring extracorporeal membrane oxygenation","volume":"11","author":"D Ginter","year":"2023","journal-title":"Front Pediatr"},{"issue":"12","key":"pone.0351214.ref010","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.1016\/j.ijporl.2014.10.021","article-title":"Management of complicated airway foreign body aspiration using extracorporeal membrane oxygenation (ECMO)","volume":"78","author":"AH Park","year":"2014","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"pone.0351214.ref011","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ijporl.2017.01.011","article-title":"Treatment of bronchial foreign body aspiration with extracorporeal life support in a child: A case report and literature review","volume":"94","author":"L Deng","year":"2017","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"2","key":"pone.0351214.ref012","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/SMJ.0b013e318193c9c8","article-title":"Tracheobronchial foreign body aspiration in adults","volume":"102","author":"M Boyd","year":"2009","journal-title":"South Med J"},{"issue":"9","key":"pone.0351214.ref013","doi-asserted-by":"crossref","first-page":"3398","DOI":"10.21037\/jtd.2017.06.137","article-title":"Foreign body aspiration in adult airways: therapeutic approach","volume":"9","author":"JC Hewlett","year":"2017","journal-title":"J Thorac Dis"},{"key":"pone.0351214.ref014","first-page":"1613","article-title":"The clinical features of foreign body aspiration into the lower airway in geriatric patients","volume":"9","author":"L Lin","year":"2014","journal-title":"Clin Interv Aging"},{"issue":"2","key":"pone.0351214.ref015","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1097\/TA.0b013e3182789520","article-title":"Inhalation of foreign bodies in children: experience of 22 years","volume":"74","author":"A Sahin","year":"2013","journal-title":"J Trauma Acute Care Surg"},{"issue":"10","key":"pone.0351214.ref016","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.4187\/respcare.03976","article-title":"Foreign body inhalation in the adult population: experience of 25,998 bronchoscopies and systematic review of the literature","volume":"60","author":"IS Sehgal","year":"2015","journal-title":"Respir Care"},{"issue":"3","key":"pone.0351214.ref017","doi-asserted-by":"crossref","first-page":"396","DOI":"10.3390\/medicina58030396","article-title":"Successful management foreign body aspiration associated with severe respiratory distress and subcutaneous emphysema: case report and literature review","volume":"58","author":"JJ G\u00f3mez-Ramos","year":"2022","journal-title":"Medicina (Kaunas)"},{"issue":"921","key":"pone.0351214.ref018","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1136\/pmj.78.921.399","article-title":"Foreign body aspiration: clinical utility of flexible bronchoscopy","volume":"78","author":"O Dikensoy","year":"2002","journal-title":"Postgrad Med J"},{"issue":"1","key":"pone.0351214.ref019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00005537-200301000-00001","article-title":"Regular tracheostomy tube changes to prevent formation of granulation tissue","volume":"113","author":"K Yaremchuk","year":"2003","journal-title":"Laryngoscope"},{"issue":"3","key":"pone.0351214.ref020","doi-asserted-by":"crossref","first-page":"240243","DOI":"10.1183\/20734735.0243-2024","article-title":"Lung implantable devices: the issue with granulation tissue","volume":"21","author":"A Gupta","year":"2025","journal-title":"Breathe (Sheff)"},{"key":"pone.0351214.ref021","article-title":"Management of foreign bodies in the airway and oesophagus","author":"H Rodr\u00edguez","year":"2012","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"2","key":"pone.0351214.ref022","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1183\/09031936.02.00204602","article-title":"ERS\/ATS statement on interventional pulmonology","volume":"19","author":"JF Beamis","year":"2002","journal-title":"Eur Respir J"},{"key":"pone.0351214.ref023","doi-asserted-by":"crossref","unstructured":"Po\u0159\u00edzka M, Mich\u00e1lek P, Votruba J, Abdelmalak BB. Extracorporeal Oxygenation Techniques in Adult Critical Airway Obstruction: A Review. Prague Med Rep. 2021;122(2):61\u201372.","DOI":"10.14712\/23362936.2021.7"},{"issue":"5","key":"pone.0351214.ref024","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jemermed.2019.01.036","article-title":"The Use of Extracorporeal Membrane Oxygenation in Life-Threatening Foreign Body Aspiration: Case Series, Review of Extracorporeal Life Support Organization Registry Data, and Systematic Literature Review","volume":"56","author":"P Anton-Martin","year":"2019","journal-title":"J Emerg Med"},{"issue":"5","key":"pone.0351214.ref025","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/j.1365-2044.1983.tb14033.x","article-title":"Emergency extracorporeal oxygenation for an intratracheal foreign body","volume":"38","author":"RJ Maharaj","year":"1983","journal-title":"Anaesthesia"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:37:33Z","timestamp":1780681053000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351214"}},"subtitle":[],"editor":[{"given":"Jamal","family":"Akhtar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0351214","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]}}}