Correlation of Ultrasound Examination with FOB for Airway Assessment in Burn Patients with Inhalational Injury: A Prospective Observational Study.

Abstract

Aim/background: Fiberoptic bronchoscopy (FOB) is the gold standard for assessing airway involvement in burn patients but is invasive. Ultrasound (USG) has not been previously used to evaluate the airway in burn patients. Our study evaluated the feasibility of using USG to assess airway involvement in inhalational burn injury and correlated its efficacy with FOB.

Materials and methods: This prospective observational study was conducted in the burns intensive care unit (ICU) of a tertiary care hospital. Bedside airway USG was performed to evaluate vocal cord (VC) width for edema and other airway parameters, including tongue thickness, pre-epiglottis space depth, inter-arytenoid distance, epiglottis-to-midpoint of VC, distance between the true VCs, distance between the false VCs, tracheal wall thickness, and tracheal air column width. Fiberoptic bronchoscopy was then performed to assess airway involvement, and findings were correlated with USG at the VC level.

Results: About 51 patients were included. Airway USG assessment was able to predict the VC edema, correlating with FOB findings in 30 patients. Ultrasound showed a sensitivity and specificity of 85.2 and 81.3%, respectively, with a positive and negative predictive value of 90.9 and 72.2%, respectively, for assessing airway edema at the level of VC. The mean right and left VC widths were 21.15 ± 9.52 mm and 22.03 ± 9.52 mm, respectively, in patients with VC edema. The pre-epiglottis space in patients with (n = 33) vs without VC edema (n = 18) was found to be statistically significant (14.5± 5.64 mm vs 10.87 ± 4.36 mm; p = 0.02).

Conclusion: Ultrasound can be used as a reliable, non-invasive bedside predictor of airway involvement in patients with suspected inhalational injury.

How to cite this article: Garg H, Agarwal S, Kumar A, Kumar S, Darlong V, Kashyap L, et al. Correlation of Ultrasound Examination with FOB for Airway Assessment in Burn Patients with Inhalational Injury: A Prospective Observational Study. Indian J Crit Care Med 2025;29(4):314-319.