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Dilution is not always the solution: A retrospective study of pulmonary lavage in inhalation injury
Journal article   Open access   Peer reviewed

Dilution is not always the solution: A retrospective study of pulmonary lavage in inhalation injury

Ashleigh Bull, Colette Galet, Samuel W Jones and Alexander Kurjatko
Journal of burn care & research, Vol.46(5), pp.995-1000
09/19/2025
DOI: 10.1093/jbcr/iraf078
PMCID: PMC12481502
PMID: 40336201
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1093/jbcr/iraf078View
Published (Version of record) Open Access

Abstract

Burned patients with inhalation injury commonly undergo bronchoscopy, at times with pulmonary lavage (PL). We characterized the outcomes of burned patients with inhalation injury who underwent PL at a single burn center in a retrospective cohort study. We included all adult patients admitted between July 1, 2015 to June 30, 2023 who were on the ventilator and diagnosed with inhalation injury. Chemical inhalation, grade 0 inhalation injury, and diagnosis of inhalation injury without bronchoscopy were excluded. Demographics, burn size and anatomic location, and hospital course information were collected. Chi-square and Fisher exact tests were used to compare categorical variables, and continuous variables were compared using the Mann-Whitney U test. Multivariate analyses were performed to identify variables associated with outcomes. P < 0.05 was considered significant. One hundred sixteen patients were included; 37 (31.9%) underwent PL. Univariate analysis showed no significant differences in age, total body surface area burned (TBSA) 2nd or 3rd degree TBSA, complication rates, or in-hospital mortality between the no-PL and PL groups. Patients in the PL group had increased ventilator days (6 [2.5-15.5] vs. 2 [1-6], p < 0.001) and hospital length of stay (LOS) (12 [4-37.5] vs. 5 [2-18], p = 0.003). Multivariate analysis showed that PL was associated with an increase in ventilator days (OR = 1.84 [1.14-2.98], p = 0.013), hospital LOS (OR = 1.717 [1.080-2.730], p = 0.022), and sepsis (OR = 7.216 [1.106-47.080], p = 0.039). In conclusion, PL was associated with longer ventilator days, longer LOS, and increased risk of sepsis.
 pulmonary lavage complications inhalation injury lavage bronchoscopy UIOWA OA Agreement

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