Incidence of post-procedure complications in children undergoing elective flexible bronchoscopy

Abstract

Background: Paediatric flexible bronchoscopy with bronchoalveolar lavage (FB-BAL) is a safe procedure with a low incidence of intra-procedure complications. There is a paucity of data on the incidence of post-procedure complications.

Aim: To investigate the incidence of post-procedure complications in children undergoing elective FB-BAL.

Methods: Retrospective case note analysis was undertaken in all children undergoing elective daycase FB-BAL at University Hospitals of North Midlands NHS Trust between August 2016 and July 2018. Those having planned post-procedure antibiotics were excluded. All children had the procedure under general anaesthetic and had six lobe (including lingula) lavage.

Results: 155 procedures were included in the analysis. The mean (SD) age at time of FB-BAL was 4.9 (4.0) years. 40 of the children had CF. 7/155 (5%) experienced immediate post-procedure complications. This resulted in discharge being delayed until the following day in three (2%) children. A further 10 (6%) children re-attended hospital within 48 hours of discharge. Five were commenced on antibiotics and two required overnight admission. Recorded complications included pyrexia, tachypnoea, cough, increased work of breathing, vomiting and reduced feeding.

Conclusions: In this cohort, 8% of children undergoing elective FB-BAL experienced side effects severe enough to delay discharge resulting in overnight admission or require the child to re-attend hospital after discharge. These risks should be discussed with children and parents when consenting for FB-BAL.