Using bronchoscopy and biopsy to diagnose early inhalation injury. Macroscopic and histologic findings.

OBJECTIVE To learn the value of bronchoscopy and biopsy in the early diagnosis of inhalation injury ARDS. SETTING Burn Center, CHU Saint-Antoine, Paris, France. DESIGN 130 consecutively admitted burn patients were bronchoscoped on admission. MEASUREMENTS The appearance of the bronchial tree was recorded, and biopsies were taken from spurs of the proximal and distal branches of the right bronchi. RESULTS Either bronchoscopy or biopsy was positive in 46 cases. Twenty three of 44 patients with chemical inhalation injury developed ARDS (52%). Of 83 negative cases only 6 developed ARDS (7%). CONCLUSION Bronchoscopy with biopsy is useful in predicting the development of ARDS in burn patients.