Virtual bronchoscopy for diagnosis of inhalation injury in burnt patients

Gore, Madhuri; Joshi, Anagha; Nagarajan, Ganesh; Iyer, Sandhya; Kulkarni, Trupti; Khandelwal, Ashish

doi:10.1016/j.burns.2003.09.024

Cited by 26 publications

(10 citation statements)

References 3 publications

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“…Even when the initial chest examination, chest x-ray, and blood gasses are normal, bronchoscopy can identify large airway injury, a precursor to respiratory complications due to inhalational injury [13,15,16]. One hundred percent of the patients (n = 20) in our study, had bronchoscopic findings of large airway injury, involving both the trachea and proximal bronchial tree.…”

Section: Discussionmentioning

confidence: 80%

“…There are many cases that are easily missed due to inhalation injury that can occur irrespective of burn injuries and clinical manifestations are often not apparent. It is reported that inhalation lung injury can occur in patients with no body surface burn; however, its clinical manifestations are not consistent and can vary from no obvious symptoms to severe respiratory failure [13]. …”

Section: Discussionmentioning

confidence: 99%

“…When the inhaled matter contains carbon based soot, the carbon soot will adhere to the mucosal surfaces of all visible airways [13]. Some patients with mild symptoms do not have any visible bronchoscopic findings consistent with inhalational injury.…”

Section: Discussionmentioning

confidence: 99%

“…Gore et al [13] describes that it is safe to perform flexible bronchoscopy in inhalation lung injury patients, even those with mild airway obstruction. In many cases, it is the personal experience of the clinician that is often the constraining factor for the use bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

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Application of flexible bronchoscopy in inhalation lung injury

et al. 2013

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BackgroundAs acute inhalational injury is an uncommon presentation to most institutions, a standard approach to its assessment and management, especially using flexible bronchoscopy, has not received significant attention.MethodsThe objective of this study is to evaluate the value of using flexible bronchoscopy as part of the evaluation and management of patients with inhalational lung injury. Twenty-three cases of inhalational lung injury were treated in our three hospitals after a fire in a residential building. The twenty cases that underwent bronchoscopy as part of their management are included in this analysis. After admission, the first bronchoscopy was conducted within 18-72 hours post inhalational injury. G2-level patients were reexamined 24 hours after the first bronchoscopy, while G1-level patients were reexamined 72 hours later. Subsequently, all patients were re-examined every 2-3 days until recovered or until only tunica mucosa bronchi congestion was identified by bronchoscopy.ResultsTwenty patients had airway injury diagnosed by bronchoscopy including burns to the larynx and glottis or large airways. Bronchoscopic classification of the inhalation injury was performed, identifying 12 cases of grade G1 changes and 8 cases of grade G2. The airway injury in the 12 cases of grade G1 patients demonstrated recovery in 2-8 days, in the airway injury of the 8 cases of grade G2 patients had a prolonged recovery with airway injury improving in 6-21 days averaged. The difference in recovery time between the two groups was significant (P <0.05).ConclusionsThe use of flexible bronchoscopy has great value in the diagnosis of inhalational injury without any complications. Its use should be incorporated into clinical practice.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1476676925108926

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Application of flexible bronchoscopy in inhalation lung injury

et al. 2013

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“…Gore et al (2) confirm that VB is particularly suitable in some diseases of the chest as bronchoesophageal fistula, after lung transplantation, anastomoses, suspected aspiration of a foreign body and respiratory disabilities. VB enables accurately to inspect the lumen and the diameter of the bronchial tree, to assess the stenoses of the airways, to visualize remote prominent lesions.…”

Section: Resultsmentioning

confidence: 97%

Virtual bronchoscopy, importance of the method, application and prospects for tumors of the trachea and bronchi

Mitev¹,

Trajkova²,

Arabadzhiev³

et al. 2017

TJS

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Virtual bronchoscopy (VB) is 3-dimensional computer-generated technology, creating endobronchial images from spiral CT data. The study aims to present summarized results from researches of different foreign authors about the advantages of VB, the possibilities for its application and the effectiveness of its use in routine practice in the diagnosis of tumors of the trachea and bronchi. The three-dimensional model of the tracheobronchial tree allows assessment of the airways from inside. The majority of the examined studies relate to the diagnosis of new formations of the respiratory tract, preparation for surgery, assessment of the results of surgery, etc. VB is a noninvasive method allowing to examine the smallest bronchi. Relatively few studies in Bulgaria as well as the ensured during recent years new modern equipment for VB and MDCT, provide great opportunities for making VB examinations to study the effectiveness and its wide application in daily X-ray practice.

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