Inhalation Injury-An Increasing Problem

Abstract

Inhalation injury is a common complication of thermal accidents occurring in one-third of patients burned. The routine use of fiberoptic bronchoscopy on all patients incurring thermal burns provides an accurate and safe means for diagnosis. Although complications for inhalation injury are common, the mortality can be reduced by early diagnosis and attention to careful fluid resuscitation, aggressive pulmonary therapy and the avoidance of prophylatic steroids.

Big Data - and its contributions to peri-operative medicine

“…Both the onset and the severity of airway oedema are difficult to predict accurately, and we know surprisingly little of the natural history of airway pathology following thermal injury [9,10]. Thermal injury to the oral cavity and throat can cause oedema; with severe injury, airway obstruction may result as a consequence of oedema of the supraglottic airway and, in particular, the false vocal cords [11]. In many cases, clinically significant obstruction only occurs following fluid resuscitation, with maximal oedema typically presenting 8-36 h after the initial insult, and lasting for up to four days [5,11,12].…”

“…Clinical signs such as facial burns, hoarseness, drooling, carbonaceous sputum and singed nasal hairs raise the possibility of airway involvement, but they are unreliable and poor predictors of injury severity [1,11,[17][18][19]. Reliance on these signs may also lead to patients with clinically significant airway involvement going undetected [18,19].…”

Smoke hoods in aeroplanes.

“…Reduced lung function and symptoms resembling those in industrial bronchitis have been found in firemen who have inhaled smoke.7 Little is known, however, about the long term effects of smoke inhalational injury, which is probably underreported. 8 What is known about the acute effects is that inhalation of smoke increases mortality from serious burns and, by incapacitating people, slows down the rate of escape from fires. The aisles and exits of aeroplanes are narrow, and it takes few bodies to block them.…”

Respiratory Effects of Short-Term, High-Intensity Toxic Inhalations: Smoke, Gases, and Fumes

“…Although some authors have advocated prophylactic corticosteroid therapy to reduce parenchymal inflammation and subsequent fibrosis [28], others have noted increased infectious complications with their use [4,27]. Although some authors have advocated prophylactic corticosteroid therapy to reduce parenchymal inflammation and subsequent fibrosis [28], others have noted increased infectious complications with their use [4,27].…”