Early Bronchoscopy as a Predictor of Ventilatory Support for Burned Patients

Twenty-seven burned patients who had facial burns, hoarseness, or evidence of carbonaceous sputum or had been in a smoke-filled enclosed space underwent fiberoptic bronchoscopy at the time of admission. Airway severity was indexed (grades 1-5, grade 5 being the most severe). Fifteen nonsurvivors had a bronchoscopic index of 3.2 +/- 1.6 and 12 survivors an index of 3.4 +/- 1.2 (p greater than 0.05). No patient died of respiratory complications. Bronchoscopic index correlated poorly with the level of positive end expiratory pressure required to maintain oxygenation in any patient (r = 0.50). Likewise, bronchoscopic index did not correlate with duration of intubation in any survivor (r = 0.33). Immediate bronchoscopy after burn injury neither indicates the level of respiratory support that will be required nor predicts its duration.