Airway obstruction and bacterial invasion in autopsy tissue of pediatric burn victims

Robert A. Cox, Sam Jacob, Yong Zhu, Ron Mlcak, Robert Kraft, David N. Herndon, Hal K. Hawkins

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalJournal of Burn Care and Research
Issue number2
StatePublished - Mar 2014

ASJC Scopus subject areas

  • General Medicine


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