Asia Pacific Journal of Pediatric and Child Health

Abstract Ref Number = APCP1219

Poster Presentation

THE SAFETY OF PERFORMING PEDIATRIC FLEXIBLE BRONCHOSCOPY PROCEDURE IN PICU SETTING : HARAPAN KITA WOMEN AND CHILDREN HOSPITAL EXPERIENCE

Rifan Fauziea, Dimas DSaputroa, RetnoWidyaningsiha, Felix b, NathanneSeptiandib, PustikaEfarb, YuliatmokoSuryatinb, Agnes Praptiwib, Henny Rositab, GuwansjahDMb aPediatricRespirology Division, Harapan Kita Women and Children Hospital, Jakarta bPediatricIntensive and Emergency Division, Harapan Kita Women and Children Hospital, Jakarta

Background: Flexible bronchoscopy is one of the main tools in pediatric respiratory management. There are many indications of the procedures. It needs sedation and some centers prefer doing the procedure in operating theatre (OT) setting. Others do it in Pediatric Intensive Care Unit (PICU). There are some advantages and disadvantages as well regarding to patient safety issue. The aim of the study is to demonstrate the safety of flexible bronchoscopy in our PICU setting. Method: It is a cross sectional study from medical records’ cases of patients were underwent flexible bronchoscopy of various indications in Harapan Kita Women and Children Hospital. We used Olympus® flexible bronchoscopy type BF XP 10F and BF XP 190 and performed mostly in our PICU setting. Results: During January to May 2018 there were 82cases of pediatric flexible bronchoscopy procedures in Harapan Kita Women and Children Hospital. Seven cases were performed in OT setting and 75 cases were done in PICU setting. There were 45 boys and 37 girls aged vary from 2 weeks to 24 months old. Thirty-nine cases were below 6 months old, 19 cases were between 6 to 12 months old and 24 cases were more than 12 months old. Mostly were from the ward (57/82), and the indications were unexplained stridor (58/82), severe pneumonia (12/82), airway re-evaluation (7/82), recurrent pneumonia (3/82) and foreign body aspiration (2/82). The sedation done by our pediatric intensivist with ketamine and midazolam intravenously as well. Close vital signs monitoring was strictly performed. There was no complication after the procedures in mostly of our patients, except one suffered from apneic attack due that was previously noticed several times at home by the parents. Conclusions: Flexible bronchoscopy is the safe procedure in pediatrics. The procedure safely done in PICU settings. No serious complications noticed in our patients.

Keywords: pediatric flexible bronchoscopy sedation safety PICU setting,indications