Combined smoke inhalation and body surface burns injury does not necessarily imply long-term respiratory health consequences

Abstract

This study was undertaken to assess the long-term respiratory health consequences of smoke inhalation in patients who are burns survivors.Patients with smoke inhalation resulting from domestic flame or fire were studied. Medical records were the primary source for the selection of the patients. Smoke inhalation was diagnosed on the basis of the visual appearance of the airways on the reported bronchoscopy. Patients who participated in the study were compared on important characteristics with those who did not participate. The participants were then assessed by questionnaire, physical examination, chest radiograph and pulmonary function tests.Twenty three out of 45 patients who had survived smoke inhalation participated in the study. Participants and nonparticipants were comparable with respect to gender, age, time since injury, aetiology of injury, and total body surface burned. Participants had more facial burns, more severe bronchoscopic findings of smoke inhalation and required intubation more frequently. Respiratory symptom assessment and pulmonary function tests were performed 45±23 months after smoke inhalation. Four patients reported an increase in dyspnoea, one an increase in cough and one an increase in phlegm. All the patients had pulmonary function tests and bronchial responsiveness (provocative concentration of histamine resulting in a 20% fall in forced expiratory volume in one second (PC20)>16 mg·mL -1 ) within normal limits. The four patients complaining of increased dyspnoea had results within normal limits for cardiac and respiratory variables on maximal exertion.The present study indicates that, in burn patients, smoke inhalation resulting from a single domestic fire does not necessarily imply long-term respiratory health consequences.

Aerobic exercise training in modulation of aerobic physical fitness and balance of burned patients

“…Mlcak et al 6 ) reported that burn injury patients with inhalation injuries displayed a ventilatory rather than a cardiac limitation to exercise. Furthermore, Bourbeau et al 7 ) found that long-term pulmonary function was impaired but not below normal limits, and that exercise tolerance was unchanged in adults following inhalation injury. Conversely, Willis et al 8 ) demonstrated that adults with burn injuries, with and without inhalation injury, had a significantly lower aerobic capacity and greater oxygen desaturation during a maximal oxygen exercise test compared with healthy controls.…”

Acute Inhalation Injury

“…Uzun dönem; çoğu hasta, duman inhalasyonundan sonra uzun süreli fonksiyonel bozulma yaşamaz. Şiddetli duman inhalasyonu öyküsü olan 23 hastanın incelendiği bir çalışmada, spirometri, nonspesifik hava yolu aşırı duyarlılığı veya kardiyak parametreler maruziyetten yaklaşık dört yıl sonra ölçüldüğünde hiçbir değişiklik olmamıştır (55) . Ancak bir derlemede solunum fonksiyon bozukluğu yapan toksik inhalasyonu da olan ciddi yanıklı çocuklarda, akciğer fonksiyonunun yaralanma sonrası 10 yıla kadar düşük saptandığı belirtilmiştir (38) .…”

Inhalation injury is associated with long-term employment outcomes in the burn population: Findings from a cross-sectional examination of the Burn Model System National Database

“…Conversely, Bourbeau et. al described that exposure to smoke inhalation from a fire does not necessarily result in long-term respiratory effects up to 45 months post-injury [5,19]. Further, one study did not find inhalation injury had any effect on quality of life, though was limited to the pediatric population [6].…”

“…Studies examining long-term outcomes of inhalation injury are limited by small sample sizes or animal models [3][4][5][6]. Default proxy for diagnosis of inhalation injury is through history and physical exam, as only a few diagnostic procedures have been proposed and validated [7][8][9][10][11][12].…”