[Bronchoscopy in inhalation burns]

The treatment of burns of various depth and location which are combined with thermoinhalation affections of the respiratory organs is a serious problem during the entire course of burn disease. Despite advances in modern treatment of burns, the death rate of pulmonary complications is still high. Pulmonary disorders encountered in inhalation of chemical toxic products of burning, smoke and its finely divided components increase the fatal outcomes by 30-100% in different periods of the burn disease. Until recently, thermoinhalation affections were not often taken into account in analysis of the causes of death of patients with burns, and the diagnosis was based on scanty historical data and late clinical symptoms. In works published from the beginning of the eighties, bronchoscopy was assigned secondary significance. Evaluation of the character of the lesion, the extent and depth of pathological changes in the tracheobronchial tree in thermoinhalation affections is based in most cases on the post-mortem findings. The purpose of this work was to evaluate clinically and by laboratory studies the role and significance of bronchoscopy in establishing the diagnosis in individuals with burns and thermoinhalation damage during life, in the treatment and prevention of the expected complications in the respiratory organs, and to promote wide use of a bronchoscope in this category of seriously ill patients. On the basis of the study, the authors revealed a close correlation between respiratory insufficiency of various degree and extent and the depth of the affection of the tracheobronchial tree. They also substantiated indications for systemic bronchoscopic treatment of thermoinhalation lesions.