title: Application of flexible bronchoscopy in inhalation lung injury.
abstract: BACKGROUND
  As 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.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Twenty 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).
  
  
  CONCLUSIONS
  The use of flexible bronchoscopy has great value in the diagnosis of inhalational injury without any complications. Its use should be incorporated into clinical practice.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1476676925108926.
authors.forename: Chong
authors.initials: C
authors.lastname: Bai
authors.forename: Haidong
authors.initials: H
authors.lastname: Huang
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Yao
authors.forename: Shihui
authors.initials: S
authors.lastname: Zhu
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Jingqing
authors.initials: J
authors.lastname: Hang
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, Changhai Affiliated Hospital of the Second Military Medical University, Shanghai 200433, China. pzarog@hotmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.forename: Andreas
authors.initials: A
authors.lastname: Gschwendtner
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Michael
authors.initials: M
authors.lastname: Simoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000473:pathology; D001999:Bronchoscopy / Q000295:instrumentation* / Q000379:methods*; D002059:Burns, Inhalation / Q000175:diagnosis* / Q000473:pathology; D002681:China; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult