Skip Navigation LinksHome > March/April 2014 - Volume 35 - Issue 2 > Airway Obstruction and Bacterial Invasion in Autopsy Tissue...
Journal of Burn Care & Research:
doi: 10.1097/BCR.0b013e31828e62b8
Original Articles

Airway Obstruction and Bacterial Invasion in Autopsy Tissue of Pediatric Burn Victims

Cox, Robert A. PhD*; Jacob, Sam MS*; Zhu, Yong PhD; Mlcak, Ron PhD; Kraft, Robert MD§; Herndon, David N. MD§; Hawkins, Hal K. MD, PhD*

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This study measured airway obstruction and bacterial invasion in systematically sampled lung tissue of burn victims at autopsy. Lung tissue from victims of combined smoke inhalation and burn injury (n = 5) and burn injury alone (n = 9) was examined histologically and the degree of bronchial and bronchiolar obstruction was measured. The walls of both bronchi and bronchioles were examined for bacterial invasion. Correlation analysis was performed for the association of airway obstruction with TBSA burn, number of ventilatory days, maximum inspiratory pressure, and days after injury. There was no significant difference in the mean degree of airway obstruction in smoke inhalation and burn victims compared with victims of burn-only injury (P > .05). Increased bronchiolar obstruction scores were detected in victims with pneumonia (55.3 ± 24.2%) compared with victims without pneumonia (9.3 ± 0.2%; P = .03). Bacterial invasion of the bronchial wall was present in one case, and invasion into the walls of bronchioles was seen in five cases. Burned children who died had extensive bronchiolar obstruction whether or not they had smoke inhalation injury. There was bacterial invasion into the airway wall in six of 14 cases (43%). Improved understanding of the mechanisms of airway obstruction is important for improved care of burned children.

© 2014 The American Burn Association


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