The Value and Prognostic Role of the CT Scan versus Chest Radiography in the Follow-up of Intubated Burn Patients with Possible Inhalation Injury

The admission and follow-up chest radiographs as well as the follow-up CT scans of 13 burn patients admitted to our clinic requiring ventilatory support were analysed for signs of inhalation injury and pulmonary complications. The findings were compared with the results of the clinical examination, the blood gas tests, and bronchoscopy. Eleven out of the 13 patients underwent bronchoscopy revealing inhalation injury. The CT scan detected pleural effusion in two patients with a normal chest radiograph. In two patients the CT scan detected asymmetrical expansion between the right lung and the left. In one patient soft tissue oedema made evaluation of the chest radiograph impossible, while the CT revealed bilateral pleural effusions and consolidations or atelectasis in both the lower lobes. In one patient the CT scan detected oedema of consolidatory pattern in every lobe (superior middle-inferior), while the image in the chest radiograph was not similar. CT identified an area of consolidation in one patient in the right middle lobe with a normal chest radiograph. The results of the CT scan correlated with the clinical course and blood gas determinations, while similar findings in the chest radiograph were observed at a later stage. In conclusion, compared to chest radiographs, the CT scan often yielded additional information in the follow-up of intubated burn patients with inhalation injury. It can be performed in order to confirm and/or more precisely define the full extent of lung injury and is also feasible in patients who are critically ill and hard to move.