First-day Computed Tomography: Does it Has a Role in the Assessment of Patients With Inhalation Lung Injury?

Study Overview
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Brief Summary
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A major risk factor for death in burn victims is inhalation lung injury. Diagnostic criteria and severity grading are not well understood. After an inhalation injury, the mucociliary escalator is impaired by induced mucosal hyperemia, which includes Edema, increased mucous production, and airway exudation, and these insults worsen airway narrowing which interferes with ventilation. Multimodal therapy and quick bronchoscopic diagnosis improve patient outcomes. Early identification and classification of inhalation injuries improve patient outcomes. Chest CT may be employed as an alternative to or supplement to the bronchoscopy as well as a diagnostic and prognostic tool. In this study, the diagnostic and prognostic value of bronchial wall thickening as a radiological CT finding in inhalation lung damage and the radiologist score (RADS) were evaluated.

Detailed Description
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Forty-eight patients with inhalation lung injury were included in the study as the case group, and ten patients without ILI were chosen as the control group. Both groups were recruited from the burn and plastic department. A fiberoptic bronchoscope was performed during the first 12 hours of a suspected ILI to confirm the diagnosis. After performing an initial chest X-ray, computed tomography was used to calculate the radiologist score (RADS) and the thickness of the bronchial walls (BWT).

Official Title
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First-day Computed Tomography: Does it Has a Role in the Assessment of Patients With Inhalation Lung Injury?

Conditions
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Inhalation Injury

Intervention / Treatment
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* Radiation: chest computed tomography (CT)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: any patient with a suspected inhalational lung injury Exclusion Criteria: less than 18 years old, patients who had their CT scan after 24 hours after their admission patients who couldn't finish all of the study steps. patients that are known to have any parenchymal lung disorders.

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cases<br>48 participants with burn injuries associated with inhalation lung injuries were recruited from the burn department. | Radiation: chest computed tomography (CT)<br>* Within the first 12 hours of suspected inhalation lung injury, fiberoptic bronchoscopy was done to confirm the diagnosis. After confirming the diagnosis, an initial chest CT in the first 24 hrs through which the radiologist score (RADS) together with bronchial wall thickening (BWT) was done.<br>|
| Active Comparator: Control<br>10 participants with burn injuries NOT associated with inhalation lung injuries were recruited from the burn department. | Radiation: chest computed tomography (CT)<br>* Within the first 12 hours of suspected inhalation lung injury, fiberoptic bronchoscopy was done to confirm the diagnosis. After confirming the diagnosis, an initial chest CT in the first 24 hrs through which the radiologist score (RADS) together with bronchial wall thickening (BWT) was done.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| bronchial wall thickening (BWT) | measured through a CT chest scan at the end inspiration 2 cm distal to the tracheal bifurcation. | 24 hours | 
| Radiologist score | CT scans of each patient were examined using 1-cm axial slices from the apex to the diaphragm level. The right and left lung fields in each slice were subdivided into 4 quadrants. Each quadrant was awarded a score ranging from 0 to 3 based on the severity of the results. The highest score inside a quadrant was awarded as the final score, and a total score was produced for each slice. The total score for each slice was then added together for the full CT scan to get the RADS overall. | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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inhalation injury, Bronchial wall thickening, Radiologist score, computed tomography.