Diagnosis and treatment of inhalation injury

Woodson, Lee C.; Talon, Mark; Traber, Daniel L.; Herndon, David N.

doi:10.1016/b978-1-4377-2786-9.00019-9

Cited by 8 publications

(10 citation statements)

References 82 publications

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“…In some burn patients it is necessary to secure the airway early (at the time of presentation). Indications of early tracheal intubation mainly include [9] : (1) overt signs and symptoms of airway obstruction; (2) extensive burns to the head and neck; (3) inability to protect airway from aspiration; (4) significant toxicity from carbon monoxide or cyanide; (5) respiratory failure; (6) extensive burns (> 40% of total body surface area); and (7) hemodynamic instability. In selected patients tracheostomy is preferred over translaryngeal route for tracheal intubation.…”

Section: Discussionmentioning

confidence: 99%

“…In selected patients tracheostomy is preferred over translaryngeal route for tracheal intubation. Indications of tracheostomy in burn patients mainly include [9] : (1) need for prolonged mechanical ventilation; (2) burns that will require multiple anesthesia for surgical procedures; and (3) extensive laryngeal oedema making translaryngeal intubation difficult. Tracheostomy tube should be removed once the need for prolonged or repeated intubation is over.…”

Section: Discussionmentioning

confidence: 99%

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Innovative cervical splint: overcoming an obstacle

Gupta¹,

Chittoria²,

Subbarao³

et al. 2018

PAR

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Cervical splints are used to maintain the neck position in burn patients with involvement of neck, which provides pain relief and prevent hypertrophic scarring and contracture. Due to the technical difficulty, cervical splinting often deferred in patients with tracheostomy. To overcome the difficulty the authors have described a simple modification of hard cervical collar, which provided adequate immobilization and adequate space for tracheostomy care. Innovative modification of hard cervical collar proposed in this case report can be a solution to overcome the difficulty posed by tracheostomy in patients sustained with neck burns.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Innovative cervical splint: overcoming an obstacle

Gupta¹,

Chittoria²,

Subbarao³

et al. 2018

PAR

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“…2 According to the most recent National Burn Repository (NBR), the percentage of patients with only smoke inhalation injury is 1.1% and with smoke inhalation injury plus burns is almost 10%. 1 Others have reported the frequency of smoke inhalation injury plus burns is as high as 19.6% 3,4 among patients admitted to burn centers.…”

Section: Introductionmentioning

confidence: 99%

Safety of Nebulized Epinephrine in Smoke Inhalation Injury

Foncerrada

Lima

Clayton

et al. 2017

Journal of Burn Care & Research

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This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD] 12 ± 4 years) with burns covering over 30% of the total body surface area (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (SOC; n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive SOC plus nebulized epinephrine (n = 8). Primary endpoints were death, chest pain, and adverse changes in cardiopulmonary hemodynamics (arrhythmia, arterial blood pressure, electrocardiographic [ST segment] changes, and peak inspiratory pressure). Additional endpoints included total days on ventilator, pulmonary function, and physiological cardiopulmonary measurements at ICU discharge. No adverse events were observed during or after the nebulization of epinephrine, and no deaths were reported that were attributable to the administration of nebulized epinephrine. The groups did not significantly differ with regard to age, sex, burn size, days on ventilator, pulmonary function, or cardiopulmonary fitness. Results of this pilot trial indicate epinephrine to be safe when administered to pediatric burn patients with smoke inhalation injury. Current data warrant future efficacy studies with a greater number of patients.

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“…Extensive research has looked at the physiological impact of inhalation injury following burns [1,2]. Woodson and colleagues [1, p. 229] defined inhalation injury as damage to the respiratory tract or pulmonary parenchyma by heat or chemical irritants carried into the airways during respiration.…”

Section: Introductionmentioning

confidence: 99%

“…Woodson and colleagues [1, p. 229] defined inhalation injury as damage to the respiratory tract or pulmonary parenchyma by heat or chemical irritants carried into the airways during respiration. The severity of the injury varies, depending on the chemical composition of the agents inhaled, the duration of the exposure, temperature reached during combustion and pre-existing co-morbidities [3–5].…”

Section: Introductionmentioning

confidence: 99%

Comparison of long-term quality of life of pediatric burn survivors with and without inhalation injury

Rosenberg

Ramirez

Epperson

et al. 2015

Burns

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Objective To examine the long-term quality of life of pediatric burn survivors with and without inhalation injuries. We hypothesized that patients with inhalation injury would report more disability and lower quality of life. Methods We examined 51 patients with inhalation injury and 72 without inhalation injury who had burns of ≥10% total body surface area, were age ≥16 years at time of the interview, and were greater than 5 years from injury. Subjects completed the World Health Organization Disability Assessment Scale II (WHODAS II) and the Burn Specific Health Scale-Brief (BSHS-B). Multiple regression analyses were used to measure the effects of inhalation injury while controlling for age at burn and TBSA. Results The mean age of burn of participants with inhalation injury was 11.7 ± 3.6 years, mean TBSA 55% ± 18, and mean ventilator days 8.4 ± 9. The mean age of burn of participants without inhalation injury was 10.3 ± 34.1 years, mean TBSA 45% ± 20, and mean ventilator days 1.3 ± 5.2. Inhalation injury did not appear to significantly impact participants' scores on the majority of the domains. The WHODAS II domain of household activities showed a significant relation with TBSA (p = 0.01). Increased size of burn was associated with difficulty completing tasks for both groups. The BSHS-B domain of treatment regimen showed a relation with age at burn (p = 0.02). Increased age was associated difficulty in this area for both groups. Conclusions Overall the groups were comparable in their reports of disability and quality of life. Inhalation injury did not affect long-term quality of life.

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Diagnosis and treatment of inhalation injury

Cited by 8 publications

References 82 publications

Innovative cervical splint: overcoming an obstacle

Innovative cervical splint: overcoming an obstacle

Safety of Nebulized Epinephrine in Smoke Inhalation Injury

Comparison of long-term quality of life of pediatric burn survivors with and without inhalation injury

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