Smoke inhalation injury is a serious threat to victims of fires and explosions, however accurate diagnosis of patients remains problematic. Current evaluation techniques are highly subjective, often involving the integration of clinical findings with bronchoscopic assessment. It is apparent that new quantitative methods for evaluating the airways of patients at risk of inhalation injury are needed. Optical frequency domain imaging (OFDI) is a high resolution optical imaging modality that enables volumetric microscopy of the trachea and upper airways in vivo. We anticipate that OFDI may be a useful tool in accurately assessing the airways of patients at risk of smoke inhalation injury by detecting injury prior to the onset of symptoms, and therefore guiding patient management. To demonstrate the potential of OFDI for evaluating smoke inhalation injury, we conducted a preclinical study in which we imaged the trachea/upper airways of 4 sheep prior to, and up to 60 minutes post exposure to cooled cotton smoke. OFDI enabled the visualization of increased mucus accumulation, mucosal thickening, epithelial disruption and sloughing, and increased submucosal signal intensity attributed to polymorphonuclear infiltrates. These results were consistent with histopathology findings. Bronchoscopic inspection of the upper airways appeared relatively normal with only mild accumulation of mucus visible within the airway lumen. The ability of OFDI to not only accurately detect smoke inhalation injury, but to quantitatively assess and monitor the progression or healing of the injury over time may provide new insights into the management of patients such as guiding clinical decisions regarding the need for intubation and ventilator support.

Date Published: 17 February 2012
PDF: 6 pages
Proc. SPIE 8207, Photonic Therapeutics and Diagnostics VIII, 82073N (17 February 2012); doi: 10.1117/12.909363

Published in SPIE Proceedings Vol. 8207:
Photonic Therapeutics and Diagnostics VIII
Anita Mahadevan-Jansen; Andreas Mandelis; Kenton W. Gregory M.D.; Nikiforos Kollias; Hyun Wook Kang; Henry Hirschberg M.D.; Melissa J. Suter; Brian Jet-Fei Wong M.D.; Justus F. Ilgner M.D.; Stephen Lam; Bodo E. Knudsen M.D.; Steen Madsen; E. Duco Jansen; Bernard Choi; Guillermo J. Tearney M.D.; Laura Marcu; Haishan Zeng; Matthew Brenner; Krzysztof Izdebski, Editor(s)