Pathophysiologic Changes in the Respiratory System After Fire Smoke Inhalation

Study Overview
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Brief Summary
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Fire smoke inhalation may contribute to intrabronchial inflammation, airway obstruction and impaired gas exchange. In this study the investigators will examine if the scope of inhalation injury can be assessed soon after hospital admission based on clinical markers, biochemical markers, Peak Expiratory Flow (PEF), spirometry and bronchoscopy. At 6 months a lung function test and metacholine test will be performed to examine whether patients have developed increased bronchial hyperreactivity (asthma) or not after the initial fire smoke exposure.

Detailed Description
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Fire smoke inhalation may contribute to intrabronchial inflammation, airway obstruction and impaired gas exchange. The scope of injury in fire smoke victims ranges from cough and minor airway irritation to severe respiratory failure and long term mechanical ventilation in the Intensive Care Unit. Some patients with high HbCO-levels are also treated with hyperbaric oxygen therapy. In this study the investigators will examine if the scope of inhalation injury can be assessed soon after admission based on clinical markers, biochemical markers, Peak Expiratory Flow (PEF), spirometry and bronchoscopy. The clinical effect of fiberoptic bronchoscopy after severe smoke inhalation will also be examined. At 6 months a lung function test and metacholine test will be performed to examine whether they have developed asthma/increased bronchial hyperreactivity or not after the initial fire smoke exposure. Lab staff (flowcytometer and cytokine analysis) are unaware of patient identity and whether the patient is a smoke-exposed patient or a healthy volunteer in the control group of non-exposed persons.

Official Title
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Pathophysiologic Changes in the Respiratory System After Fire Smoke Inhalation

Conditions
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Bronchial Asthma

Intervention / Treatment
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* Other: Fiberoptic bronchoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: fire smoke exposed patient > 18 years of age admitted to hospital Exclusion Criteria: < 18 years of ager trauma patient Control group (healthy volunteers/hospital staff): > 18 years of age non-smoker no exposure to fire smoke

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: LF tests, Fiberoptic bronchoscopy<br>Spirometry, Peak Expiratory Flow (PEF). Bronchoscopic assessment of soot in central airways. | Other: Fiberoptic bronchoscopy<br>* Fiberoptic bronchoscopy performed to remove secretions and assess soot in central airways<br>* Other names: Bronchopscopy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Positive metacholine test (bronchial hyperreactivity). | At 6 months a lung function test and metacholine test will be performed to examine whether patients have developed asthma/increased bronchial hyperreactivity after the initial fire smoke exposure. | 6 months |