Tracheobronchial cytology in inhalation injury.

The aim of this study is to establish whether tracheobronchial cytology is useful in the diagnosis of inhalation injury. Twenty patients diagnosed to have inhalation injury by existing clinical criteria and 20 control patients were admitted into the study. Bronchoscopy and brush biopsies were carried out. They were then scored using a Total Cellular Score and Differential Cellular Score. These were compared with clinical and bronchoscopic scores and respiratory outcome. The average Total Cellular Score of the patients with inhalation injury was 497.4 +/- 281.9 and that of the control patients was 1004.2 +/- 88.4. There was a strong correlation between clinical, bronchoscopic, and total cellular scores. The Differential Cellular Score showed a left shift in patients with inhalation injury. This study shows that tracheobronchial cytology is a useful adjunct in diagnosing and assessing the severity of inhalation injury. Furthermore, our results suggest that it may be superior to current methods in predicting respiratory outcome.