Incidence of Pneumonia following Bronchoscopy and Bronchoalveolar Lavage in Burn Patients.

Abstract

The standard modality for diagnosis of smoke inhalational injury in burn patients is bronchoscopy with or without bronchoalveolar lavage. However, the risks associated with these procedures are poorly described in established literature. We sought to investigate the association between diagnostic bronchoalveolar lavage at admission and the development of pneumonia in burn patients. This retrospective analysis of intubated burn patients studied those who underwent bronchoscopy on admission, comparing patients who received bronchoalveolar lavage to those who did not. Demographics and baseline characteristics were analyzed using chi-squared or Student's t-test. Unadjusted and multivariable logistic regression studies assessed the effect of admission bronchoalveolar lavage on development of pneumonia. Out of the 196 patients who underwent bronchoscopy, 98 met our criteria for analysis. The bronchoalveolar lavage group was more likely to be male and have a higher grade of abbreviated injury score. Patients who received bronchoalveolar lavage were more likely to develop pneumonia during the admission in both unadjusted and multivariable logistic regression models. These patients also had a longer hospital length of stay, greater number of ventilator days, and were more likely to undergo second bronchoscopy. These findings associate admission bronchoalveolar lavage with increased risk of pneumonia during the index hospitalization, suggesting a judicious use of bronchoalveolar lavage during admission bronchoscopy in burn patients.