Utility and safety of portable flexible bronchoscopy in children done out of the operation theatre(OT) setting in a resource-limited setting from Nepal

<bold>Background:</bold> Although flexible bronchoscopy (FB) has been an important diagnostic tool for the diagnosis of respiratory disorders in children, there is limited experience on the safety, feasibility, and clinical utility of flexible bronchoscopy(FB) in children done out of the operation theatre(OT) from a developing country like Nepal using a portable video bronchoscope <bold>Objectives:</bold> To study the utility and safety of portable pediatric bronchoscopy done outside the OT setting. <bold>Method:</bold> Records of FB performed using a portable video bronchoscope (hugemed 3.9/1.2) in the hospital from April 2021 and September 2023 were reviewed for clinical details, indications, findings, bronchoalveolar lavage, and complications. <bold>Results:</bold> Out of the total 173(aged 1.5 to 180 months) cases of FB, Persistent collapse 45(25.7%) and noisy breathing 35(20%) were the most common indications for bronchoscopy. Secretions 40(88%) and lower airway malacia 22(60%) were the most common findings in the above two groups respectively. BAL culture was present in 18 (24 %) of 75 cases with persistent pneumonia. Transient desaturation was present in 45 (25.7%) of cases and there were 2 cases of desaturation requiring bag and mask ventilation. Postbronchoscopy fever was observed in 12(6%) cases. <bold>Conclusion:</bold> FB is a useful tool to make diagnoses of various respiratory conditions by helping in anatomical assessment and microbiologic sampling. It is safe and well tolerated in children even in the out of OT setting.