• Jae Hyek Choi, Li-Dek Chou, Teryn R Roberts, Brendan M Beely, Daniel S Wendorff, Mark D Espinoza, Kyle Sieck, Alexander T Dixon, David Burmeister, Bryan S Jordan, Matthew Brenner, Zhongping Chen, Corina Necsoiu, Leopoldo C Cancio, and Andriy I Batchinsky.
• The Geneva Foundation, Tacoma WA, United States; United States Army Institute of Surgical Research, JBSA Ft. Sam Houston, TX, United States. Electronic address: jae-hyek.choi.ctr@mail.mil.
• Burns. 2019 May 1; 45 (3): 589-597.

BackgroundThe prevalence of acute respiratory distress syndrome (ARDS) in mechanically ventilated burn patients is 33%, with mortality varying from 11-46% depending on ARDS severity. Despite the new Berlin definition for ARDS, prompt bedside diagnosis is lacking. We developed and tested a bedside technique of fiberoptic-bronchoscopy-based optical coherence tomography (OCT) measurement of airway mucosal thickness (MT) for diagnosis of ARDS following smoke inhalation injury (SII) and burns.Methods16 female Yorkshire pigs received SII and 40% thermal burns. OCT MT and PaO2-to-FiO2 ratio (PFR) measurements were taken at baseline, after injury, and at 24, 48, and 72h after injury.ResultsInjury led to thickening of MT which was sustained in animals that developed ARDS. Significant correlations were found between MT, PFR, peak inspiratory pressure (PIP), and total infused fluid volume.ConclusionsOCT is a useful tool to quantify MT changes in the airway following SII and burns. OCT may be effective as a diagnostic tool in the early stages of SII-induced ARDS and should be tested in humans.Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

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