The Influence of Inhalation Injury and Pneumonia on Burn Mortality

Shirani, Khan Z.; Pruitt, Basil A.; Mason, Arthur D.

doi:10.21236/ada183028

Cited by 39 publications

(47 citation statements)

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“…Combined burn and smoke inhalation injury induced significant increases in histopathology scores and histologically determined airway obstruction in the current study ( Figure 1); however, the COHb level in arterial blood was not predictive of the grade of histological alterations (Figures 3 and 4). Because the pulmonary processes following burn and inhalation trauma are multifaceted [1][2][3], it is conceivable that the grade of histological damage is not mainly dependent on the amount of COHb formation, but other toxic chemicals, including hydrogen cyanide and hydrogen chloride. In this regard, a previous study in our ovine model revealed that CO poisoning by inhalation of 2% CO in air was associated with a similar increase in arterial COHb levels as inhalation injury induced by cotton smoke, but CO poisoning alone did not induce pulmonary dysfunction [19].…”

Section: Figure 3 Scatter Plots Of (A) Congestion Score (B) Edema Scmentioning

confidence: 99%

“…However, we have previously demonstrated that no significant lung injury occurs with burn alone [22]. Additionally, it is well known that the combination injury results in more severe injury than with smoke alone [2,3,22]. Furthermore, most patients with inhalation injury also suffer from severe burns and consequently we chose this model to closely imitate the clinical situation.…”

Section: Figure 3 Scatter Plots Of (A) Congestion Score (B) Edema Scmentioning

confidence: 99%

“…The histological alterations after inhalation injury are characterized by mucosal hyperemia, increased microvascular permeability and edema formation, acute inflammatory cell influx, and increased mucous secretion, together contributing to the formation of obstructive casts. When smoke inhalation is combined with burn injury, the physiological responses are different and even more severe than with either injury alone [2,3]. Thus, early diagnosis and appropriate treatment of concomitant inhalation injuries are of great clinical importance in the care of thermally injured patients.…”

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confidence: 99%

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Predictive role of arterial carboxyhemoglobin concentrations in ovine burn and smoke inhalation-induced lung injury

Lange¹,

Cox²,

Enkhbaatar³

et al. 2011

Experimental Lung Research

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Inhalation injury frequently occurs in burn patients and contributes to the morbidity and mortality of these injuries. Arterial carboxyhemoglobin has been proposed as an indicator of the severity of inhalation injury; however, the interrelation between arterial carboxyhemoglobin and histological alterations has not yet been investigated. Chronically instrumented sheep were subjected to a third degree burn of 40% of the total body surface area and inhalation of 48 breaths of cotton smoke. Carboxyhemoglobin was measured immediately after injury and correlated to clinical parameters of pulmonary function as well as histopathology scores from lung tissue harvested 24 hours after the injury. The injury was associated with a significant decline in pulmonary oxygenation and increases in pulmonary shunting, lung lymph flow, wet/dry weight ratio, congestion score, edema score, inflammation score, and airway obstruction scores. Carboxyhemoglobin was negatively correlated to pulmonary oxygenation and positively correlated to pulmonary shunting, lung lymph flow, and lung wet/dry weight ratio. No significant correlations could be detected between carboxyhemoglobin and histopathology scores and airway obstruction scores. Arterial carboxyhemoglobin in sheep with combined burn and inhalation injury are correlated with the degree of pulmonary failure and edema formation, but not with certain histological alterations including airway obstruction scores.

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Section: Figure 3 Scatter Plots Of (A) Congestion Score (B) Edema Scmentioning

confidence: 99%

Section: Figure 3 Scatter Plots Of (A) Congestion Score (B) Edema Scmentioning

confidence: 99%

mentioning

confidence: 99%

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Predictive role of arterial carboxyhemoglobin concentrations in ovine burn and smoke inhalation-induced lung injury

Lange¹,

Cox²,

Enkhbaatar³

et al. 2011

Experimental Lung Research

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“…The mortality rate following smoke inhalation ranges from 45% to 78%. 4 One study 5 estimated that the burn, related death rate is 20% higher in people with combined inhalation injury and cutaneous burns than in those with cutaneous burns alone.…”

Section: Smoke Inhalation Injurymentioning

confidence: 99%

Smoke inhalation injury

Lee‐Chiong

1999

Postgraduate Medicine

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“…In fire accidents, only a minority of deaths and injuries are due to heat and flames, while many victims succumb to the effects of noxious fire effluents [1,2], It has been estimated that more than 50% of the approximately 8,000 fire-related deaths occurring each year in the USA can be ascribed to inhalation-related injuries [3,4], Shirani et al [5] reported a 20% increased risk of mortality in smoke inhalation victims compared with those who suffered only from burns.…”

Section: Introductionmentioning

confidence: 99%

Carbon Monoxide Poisoning in Fire Victims

Locarelli¹,

Candura²,

Maccarini³

et al. 1994

Indoor Built Environ

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During fires, the effects of heat and noxious effluents are cumulative in causing injury to the victims. Carbon monoxide (CO), which is invariably present as a toxic component of fire emissions, often acts synergistically with cyanide released by various materials. Clinical findings are variable, depending on the extent of external burns, upper airway and lung damage, and toxic exposure. Neuropsychiatrie symptoms and respiratory distress are common manifestations. Life-threatening complications, such as pulmonary oedema, may suddenly develop up to several days after the smoke exposure. Therapeutic measures include general supportive care as well as the treatment of bums and associated systemic toxicity. Arterial blood gases, carboxyhaemoglobin and cyanide levels should be monitored. Patients exposed to significant concentrations of CO require hyperbaric oxygen therapy. Suspected cyanide poisoning must be treated without the waiting for laboratory confirmation. Untimely or incorrect intervention may compromise the chances of survival and seriously affect the future health status of fire victims.

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The Influence of Inhalation Injury and Pneumonia on Burn Mortality

Cited by 39 publications

References 1 publication

Predictive role of arterial carboxyhemoglobin concentrations in ovine burn and smoke inhalation-induced lung injury

Predictive role of arterial carboxyhemoglobin concentrations in ovine burn and smoke inhalation-induced lung injury

Smoke inhalation injury

Carbon Monoxide Poisoning in Fire Victims

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