Thussu T, Tiwari V K, Suri J C, Sarabahi S
Vivekanand Medical Institute, Palampur, Himachal Pradesh, India.
VMMC and Safdarjung Hospital, New Delhi, India.
Ann Burns Fire Disasters. 2023 Mar 31;36(1):40-48. eCollection 2023 Mar.
Airway edema following burns is a typical occurrence. It poses a threat, independent of percent Total Burn Surface Area (TBSA), to the life of the patient. Fiber optic bronchoscopy is the gold standard in its diagnosis and is preferred if the facilities are present. Its availability remains a problem in the majority of burn centers in developing countries like India. Ascoring system based on clinical findings, if formulated in a manner that reflects bronchoscopy results, may help not only with diagnosis but also with airway management in inhalation burns. One hundred patients suffering from facial burns were included in the study. They were observed clinically and bronchoscopically and airway was managed on the basis of clinical, biochemical and bronchoscopic findings. Fifty patients who showed significant bronchoscopic findings on day 1 were followed up. Clinicobronchoscopic correlation revealed a positive correlation of various clinical variables as well as bronchoscopic grading with subsequent need for endotracheal intubation. Edema of tongue/floor of the mouth and palatal edema showed a positive correlation with subsequent need for tracheostomy. This clinicobronchoscopic correlation was then used retrospectively to formulate the Safdarjung Hospital 'INHALATION' score. This score can be used for predicting impending airway compromise when bronchoscopy facilities are not readily available.
烧伤后气道水肿是一种常见情况。它对患者生命构成威胁，与烧伤总面积百分比无关。纤维支气管镜检查是其诊断的金标准，若具备相关设备则优先选用。在印度等发展中国家的大多数烧伤中心，其可用性仍是一个问题。基于临床发现制定的评分系统，若能以反映支气管镜检查结果的方式构建，则不仅有助于诊断，还能辅助吸入性烧伤的气道管理。该研究纳入了100例面部烧伤患者。对他们进行了临床和支气管镜观察，并根据临床、生化和支气管镜检查结果进行气道管理。对50例在第1天显示出明显支气管镜检查结果的患者进行了随访。临床与支气管镜检查的相关性显示，各种临床变量以及支气管镜分级与随后气管插管的需求呈正相关。舌/口底水肿和腭水肿与随后气管切开的需求呈正相关。然后回顾性地利用这种临床与支气管镜检查的相关性来制定萨夫达容医院“吸入性”评分。当支气管镜检查设备不易获得时，该评分可用于预测即将发生的气道损害。
