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Role of Flexible Bronchoscopy in Ventilator-Dependent Neonates. OBJECTIVE: To assess the usefulness and safety of flexible bronchoscopy in ventilated neonates with extubation failure. METHODS: This was a prospective observational study. Flexible bronchoscopy was done in eligible patients with failure of extubation form invasive ventilation. The main outcome measure was to find the presence of any anatomic or dynamic abnormalities of the airways of these patients and the organism profile of bronchoalveolar lavage (BAL) fluid. RESULTS: Forty-eight babies (68.8% preterm) were enrolled in the study. The most common finding on bronchoscopy was airway edema seen in 13 (27%) patients. BAL culture was positive in 29 (74%) patients. Overall treatment was modified in 35 (73%) patients based on bronchoscopy findings/BAL culture. Majority of infants (83.3%) tolerated the procedure very well. CONCLUSIONS: Flexible bronchoscopy provides useful information in the management of newborn babies with extubation failure.