Fiber-optic Bronchoscopic Classification of Inhalation Injury: Is That Consistent with Pathologic Findings?

ABSTRACT

PURPOSE: Fiber-optic bronchoscopy is widely used for early diagnosis of inhalation injury. The aim of the study was to ascertain whether a correlation could be shown between bronchoscopic and pathologic grading. METHODS: One hundred seventy patients who underwent bronchoscopy with suspicious inhalation injury were review retrospectively from January 2008 to December 2009. The patients were divided into four groups (normal, mild, moderate, severe) according to bronchoscopic and pathologic findings respectively. RESULTS: Diagnosis of an inhalation burn was confirmed in 142/170 patients, of whom upon initial assessment an inhalation trauma was suspected. Bronchoscopic grading was noted mild (n=109), 56 ALI (51.4%), 18 ARDS (16.5%); moderate (n=31), 22 ALI (71.0%), 13 ARDS (41.9%); severe (n=2), 2 ALI (100%). Pathologic grading was noted mild (n=131), 77 ALI (58.8%), 27 ARDS (20.6%); moderate (n=4), 2 ALI (50%), 1 ARDS (25%); severe (n=1), 1 ALI (100%). Consistency of two groups was not significant (P<0.05). CONCLUSION: Any burn patient highly suspicious for inhalation injury should receive an early bronchoscopy for diagnosis and treatment. Fiber-optic bronchoscopy is a safe and effective method for early diagnosis of inhalation injuries. The consensus of classification about inhalation injury will be developed.