Complications of flexible bronchoscopy in children - a retrospective cohort study

<bold>Introduction:</bold> Major complications from flexible bronchoscopies in children are rare. Intraoperative oxygen need is common, however risk of ongoing oxygen need overnight post-operatively is unknown. <bold>Aims:</bold> Describe the need for oxygen support in children following elective bronchoscopy at a single specialist centre, and associated risk factors. <bold>Methods:</bold> Electronic clinical notes of children undergoing elective bronchoscopy between 2021-2023 were reviewed. Interventional procedures, and those in children on long-term ventilation or oxygen were excluded. Demographics, medical comorbidities, and the need for oxygen overnight were recorded. Logistic regression was used to explore the relationship between comorbidity and need for oxygen overnight. <bold>Results:</bold> 99 children were included (median age 5 years, 57% male). The most common co-morbidity was chronic respiratory disease (44%) (CRD) including cystic fibrosis and bronchiectasis. Nine (9%) children required oxygen overnight. Only two of these children were older than 5 years. No major complications (pneumothorax, bleeding) occurred. The only significant comorbidity associated with need for oxygen overnight was CRD (OR 10.8; 95%CI 1.04 to 111.3; p=0.046). <bold>Conclusion:</bold> Flexible bronchoscopy is generally safe and well tolerated in children. Risk of overnight oxygen was greatest in young children under 5 years and those with CRD. The majority do not require overnight hospitalisation post-procedure. <fig><object-id>erj;64/suppl_68/PA543/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>