Assessment of fiberoptic bronchoscopic examination in inhalation injury--analysis of 32 cases

68 times of fiberoptic bronchoscopic serial examinations in 32 patients with inhalation injury were performed at early stage after injury. Bronchoscopic abnormalities including congestion, erythema, edema and necrosis were observed. Patients were divided into three groups according to the degree of damage: mild, moderate and severe. 8 patients with mild inhalation injury, their bronchoscopic abnormalities included slight congestion and edema, these changes extended to the carina with disappearance of the trachea rings, airway lumen was slight narrowed, carina was blunted, these lesions were resolved within one week after injury. The fiberoptic bronchoscopy of patients with moderate injury showed moderate congestion and edema of mucosa of the trachea, disappearance of the trachea rings, the lumen was more narrowed as compared with mild injury. The blunted carina widen to 0.5 cm due to swelling, the mucosa of primary bronchus showed slight congestion and edema. These lesions were resolved 2 weeks after injury. The fiberoptic bronchoscopic abnormalities of 13 patients with severe inhalation injury were extreme congestion and edema of the trachea mucosa with necrosis; hemorrhage and ulceration of the mucosa were seen. The trachea lumen was significantly narrowed, the carina widened to 1 cm, and even the primary bronchus mucosa manifested moderate congestion and edema with necrosis. However, secondary bronchus mucosa was only slightly damaged. All lesions resolved about three weeks after injury. The results of the fiberoptic bronchoscopy correlated with the clinical course, blood gas analysis, as well as the prognosis.