Clinical, radiological and bronchoscopic evaluation of inhalation injury cases treated at the burn center

Abstract

We aimed to introduce inhalation injury, pulmonary complications and mortality-related factors on the basis of clinical, radiological and bronchoscopic findings in patients with inhalation burns. Between January 2009 and January 2010, patients hospitalized in the intensive care unit (ICU) of a burn center who were diagnosed as inhalation burn and underwent bronchoscopy were included in the study. Demographic findings, burn type, burn percentage, clinical-laboratory features, chest Xray findings on the first and fifth days, and bronchoscopic lesions were obtained from patient files. Bronchoscopic findings were classified, and bronchoscopic score for each patient was calculated. Clinical, laboratory and radiological findings, length of stay in the ICU, and bronchoscopic scores of patients who were discharged versus of those who died were compared, and mortality-related factors were investigated. Twenty-nine patients (25 male, 4 female; mean age 40.1 +/- 3.4 years) were included. Radiological abnormalities were found in 41.3% and 65.5% of patients on the first and fifth days of hospitalization, respectively. There were no complications related to bronchoscopy. Percentage of burn and duration of stay in the ICU were higher in patients who died than in discharged patients (20.4%-48.5%, p = 0.003; mean: 7.0-13.7 days, p = 0.037, respectively). Of patients who died, 79.1% showed radiological abnormality and 50% had acute respiratory distress syndrome (ARDS) on the fifth day of hospitalization. There were no pathologic findings on chest X-ray and no ARDS was seen on the fifth day in patients who were discharged (p < 0.05). Inhalation burns in patients with cutaneous burns cause a high percentage of pulmonary complications and increase mortality. Bronchoscopy must be performed early for diagnosis, and close follow-up of these patients is necessary.