Respiratory effects of short-term, high-intensity toxic inhalations: smoke, gases, and fumes. J Intensive Care Med 1987;2:260-278.Respiratory insufficiency resulting from inhalation of hot air, smoke, or toxic gas is a common cause of death in fire victims. Toxic gas inhalation in settings other than fires is a less common but still important cause of death and disability. Pulmonary inhalation injury and systemic intoxication from exposure to a variety of agents are discussed with regard to their pathogenesis, pathophysiology, diagnosis, and treatment. Upper airway obstruction and noncardiogenic pulmonary edema are the lifethreatening respiratory complications in the immediate postinhalation period. Carbon monoxide and hydrogen cyanide intoxication are frequently associated with inhalation injury in fire victims. Early recognition and treatment of inhalation injury and systemic intoxication in victims of fires and industrial and environmental accidents could well result in improved survival.