Behandlungsstrategien des akuten Rauchgasinhalationstraumas

Maybauer, Dirk M.; Traber, D. L.; Radermacher, Peter; Herndon, David N.; Maybauer, M. O.

doi:10.1007/s00101-006-1050-3

Cited by 13 publications

(3 citation statements)

References 42 publications

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“…Über 80% der durch Verbrennungen verursachten Todesfälle sind auf ein Inhalationstrauma zurückzufüh-ren. Danach ergeben sich für Deutschland zwischen 500 und 600 Tote/Jahr durch RGI [37,45].…”

Section: Epidemiologieunclassified

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Pathophysiologie des akuten Lungenversagens bei Schwerbrandverletzten mit Inhalationstrauma

et al. 2009

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This review article describes the pathophysiological aspects of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), induced by combined burn and smoke inhalation and examines various therapeutic approaches. The injury results in a fall in arterial oxygenation as a result of airway obstruction, increased pulmonary transvascular fluid flux and loss of hypoxic pulmonary vasoconstriction. The changes in cardiopulmonary function are mediated by reactive oxygen and nitrogen species. Nitric oxide (NO) is generated by both inducible and constitutive isoforms of nitric oxide synthase (NOS). Recently, neuronal NOS emerged as a major component within the pathogenesis of ARDS. NO rapidly combines with the oxygen radical superoxide to form reactive and highly toxic nitrogen species such as peroxynitrite. The control of NO formation involves poly(ADP-ribose) polymerase and its ability to up-regulate the activity of nuclear transcription factors through ribosylation. In addition, present data support a major role of the bronchial circulation in the injury, as blockage of bronchial blood flow will also minimize the pulmonary injury. Current data suggest that cytotoxins and activated cells are formed in the airway and carried to the parenchyma.

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Section: Epidemiologieunclassified

“…empfehlenden Charakter. Ein gesicherter Nachweis zur Wirksamkeit der ICS bei RGI ist derzeit nicht verfügbar, sodass die Anwendung lediglich einen individuellen Behandlungsversuch darstellt und allgemein nicht empfohlen werden kann [37,45].…”

Section: Verletzung Von Lungenparenchym Und Alveolenunclassified

Pathophysiologie des akuten Lungenversagens bei Schwerbrandverletzten mit Inhalationstrauma

et al. 2009

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“…This can cause upper airway obstruction and contribute to pulmonary failure with severe hypoxaemia due to V/Q mismatch. 5 This warrants the need for intubation, paralysis and mechanical ventilation. Early endotracheal intubation should be done at the earliest suspicion of inhalation injury before airway oedema develops.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Life Support in Adult Burn Care: A Systematic Review

et al. 2023

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We sought to review the role of extracorporeal membrane oxygenation (ECMO) for the management of burn and smoke inhalation injury in the adult patient population. Therefore, we conducted a systematic search of the literature according to specific combination of key words to ascertain the effectiveness of this support strategy. A total of 26 articles were filtered out of 269 and considered suitable for this study. The PICOS approach and PRISMA flow chart were followed for the purposes of our review. Although there is growing evidence supporting the role of ECMO as an option for burn injury in the adult patient population, this strategy should be considered if a likely successful outcome is expected.

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