Heart failure is not an uncommon complication of tracheal foreign bodies. Secondary lesions of varying degrees of severity can occur in the bronchus and lungs after a tracheal foreign body, such as pulmonary atelectasis, bronchopneumonia, pulmonary emphysema, and pulmonary abscess, which are important causes of heart failure in pediatric patients. All these lesions are important causes of heart failure in children, and if they are not diagnosed and treated in a timely manner, the lives of the children will be seriously jeopardized. We have made early diagnosis and appropriate treatment for 28 cases of heart failure combined with tracheal foreign bodies, and obtained good therapeutic effects. Now we report as follows. 1. Data and methods 1.1 General data: from 1978 to 1997, a total of 347 cases of children with tracheal foreign bodies were admitted, and there were 28 cases of patients with combined heart failure. The incidence rate of tracheal foreign bodies combined with heart failure was about 8.1%, with 11 cases of males and 17 cases of females; the age of the patients was 10 months to 3 years old, with an average of 17 months; the duration of the disease was the shortest of 6 h, and the longest of 3 months. Types of foreign bodies and parts of the disease: 9 cases of peanuts, 3 cases of fava beans, 5 cases of sunflower seeds, 4 cases of watermelon seeds, 2 cases of soybeans, 2 cases of apple pieces, 1 case of sliced meat, 1 case of potato pieces, 1 case of kidney beans; 19 cases of foreign bodies in the right bronchial tube and 9 cases of foreign bodies in the left bronchial tube. 1.2 Clinical manifestations: children in this group averaged 62 breaths/min when calm, heart rate was the slowest 176 beats/min, the fastest 216 beats/min, an average of 182 beats/min, heart sounds were low and dull, and the prancing heart rhythm could be detected; the liver was enlarged, and the left subcostal area was 2-3 cm; cyanosis was present in 19 cases, and there were 8 cases of anuria, and the healthy side could be detected and more wet sounds were present in 8 cases, and after the removal of the foreign body, there were 9 cases of smelled wet sounds. In 8 cases, more wet sounds could be detected on the healthy side, and more wet sounds could be detected in the lungs after the removal operation in 20 cases. There were 20 cases with more wet sounds in the lungs after removal. 1.3 Diagnosis and complications: 8 cases of heart failure were diagnosed before operation, 20 cases were diagnosed after operation; other complications in this group included 3 cases of acute laryngitis, 3 cases of acute laryngotracheobronchitis, 7 cases of bronchopneumonia, 9 cases of emphysema, 5 cases of mediastinal emphysema, 6 cases of pulmonary atelectasis, 2 cases of lung abscess. 1.4 Anesthesia and treatment methods: 2 cases of ether anesthesia, 5 cases of vinyl chloride + ether anesthesia, 8 cases of ketamine anesthesia, 7 cases of sodium hydroxybutyrate anesthesia, 6 cases of isoproterenol anesthesia . In this group, 8 cases of heart failure were diagnosed before operation, 20 cases of heart failure were found after operation, all of them were given high-frequency jet oxygenation, rapid administration of cediran was used to correct heart failure, 17 cases of heart failure were corrected after saturation, 9 cases of digoxin was used for maintenance treatment, and 2 cases died of treatment failure. The preoperative diagnosis of heart failure in children were under the condition of heart failure control, timely surgery to remove the foreign body; postoperative detection of heart failure in children in addition to the application of cardiotonic agents, but also given diuretics and hormone therapy. The above treatment measures were carried out under oxygen saturation monitoring and electrocardiographic monitoring, and the surgeon, anesthesiologist and pediatrician worked closely together. Discussion Heart failure is a serious complication of bronchial foreign bodies, often endangering the patient’s life. In addition to obstructive lesions such as pulmonary atelectasis and emphysema, complications such as septic tracheobronchitis, aspiration pneumonia, or lung abscess can occur due to chemical irritation, metabolic reactions, and contamination of the foreign body. Tracheal foreign body caused by pulmonary atelectasis, can pull the mediastinum and heart to the affected side, compression of the thin wall of the atrium, damage to the myocardium; at the same time, due to the blood through the atelectasis can not be fully absorbed oxygen, insufficiently oxygenated blood flow into the left heart, affecting the function of the left heart. And purulent trachea to tracheitis, lung abscess and other complications of the pathological manifestations of mucosal swelling, luminal inflammatory exudate increased, resulting in increased secretion, the clinical can be manifested as severe dyspnea and hypoxemia, pediatric cough reflexes are poor, coughing ability is weak, and further aggravate the symptoms of dyspnea. Long-term hypoxemia, is bound to make the lung capillaries highly congested, blood can penetrate into the alveoli, pulmonary capillary permeability increases, pulmonary edema occurs, and finally can lead to right heart failure. This group of tracheal foreign body disease duration varies, are due to the combination of infection, emphysema, pulmonary atelectasis, etc., the control is not timely enough, effective, varying degrees of dyspnea manifestations, and ignored the diagnosis of heart failure, tracheal foreign body combined with the diagnosis of heart failure should be based on the diagnosis of a clear tracheal foreign body, the typical clinical manifestations of rapid, shallow breathing; frequency of up to 50 ~ 100 times / mi n, increased heart rate Typical clinical manifestations include rapid and shallow respiration; frequency up to 50~100 beats/mi, rapid heart rate up to 150~200 beats/min, most of them can hear gallop rhythm, liver enlargement up to more than 2~3 cm below the rib cage, dry and wet sounds in the lungs, cyanosis of face and lips, irritable sweating, and enlargement of the heart as shown by chest radiographs or X-rays. Although electrocardiography cannot indicate the presence or absence of heart failure, it can suggest changes in atrial and ventricular function and cardiac rhythm, which can help further diagnosis and guide the application of digitalis. Once the diagnosis of heart failure is confirmed, active and effective treatment should be taken. At the same time, broad-spectrum antibiotics should be used in high doses to control lung inflammation and reduce hypoxia [2]. While actively correcting heart failure, the timing of removing the tracheal foreign body should be mastered in due time to eradicate the causes of heart failure; for the combination of heart failure after the removal operation, oxygen, cardiotonic diuretic and other therapeutic measures should be given. Bronchial foreign body operation under local anesthesia or no anesthesia, is bound to make the child struggle, increased oxygen consumption, coupled with hypoxia and carbon dioxide retention, tracheoscopy, sympathetic nerve excitation, sinus tachycardia, can be triggered to aggravate heart failure. Therefore, it is appropriate to use general anesthesia, ketamine general anesthesia, although it has a fast effect, short duration of action, quick awakening, no inhibition of respiration, circulation characteristics, but prone to laryngospasm and aggravate the condition. Preliminary experience suggests that it is best not to use ketamine general anesthesia. Correction of heart failure often use cediran rapid saturation dosage administration method. 3 ~ 4 mg/kg for 2 years of age, 2 years of age or older use 2 ~ 3 mg/kg intravenous administration, the first time with 2/3, the remaining 1/3 according to the condition of the 2 ~ 4 h after the administration of the drug, in the removal of foreign bodies, correction of heart failure, control of inflammation in the lungs, the condition of the stable can be discontinued. In this group, 28 cases of rapid drug administration, 17 cases of heart failure were corrected quickly, 9 cases of heart failure were basically under control, and digoxin was used to maintain the other 2 cases, 1 of which was combined with atrial septal defect and severe pulmonary infection and failed to correct heart failure and died; another case of foreign body history of up to 3 months, had been misdiagnosed as “pneumonia”, the treatment was ineffective, and it was found that the foreign body had been wrapped, and the granulation was removed by forceps first, and the foreign body was then removed. During the operation, it was found that the foreign body had been wrapped up, and the granulation was firstly clamped off, and finally the foreign body was removed, and a large amount of purulent secretion was suctioned out. The operation took a long time, and after pulling out the tracheoscopy, it was found that there was pink foamy sputum, which was complicated with pulmonary edema and heart failure, and died after the failure of treatment through the symptomatic, cardiotonic, diuretic and other first aid measures. In the process of using digitalis, its therapeutic amount is similar to the amount of intoxication, and is prone to toxic reactions, so it is necessary to control the dosage and closely observe its toxic reactions.