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.