Inhalation Injury

Jones, Samuel; Williams, Felicia N.; Cairns, Bruce A.; Cartotto, Robert

doi:10.1016/j.cps.2017.02.009

Cited by 57 publications

(14 citation statements)

References 56 publications

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“…Con el tiempo las lesiones pueden resolver o progresar a la formación de sinequias, traqueomalacias, ulceraciones o granulomas secundaria a la cicatrización y remodelación anómala, deformando o produciendo obstrucción respiratoria. 4 Las víctimas de la lesión por inhalación pueden desarrollar síndrome de dificultad respiratoria, complicaciones como traqueobronquitis, bronquiectasias, bronquiolitis y neumonía (38-60%). 5 Las recomendaciones para el manejo de la vía aérea quemada incluyen la intubación temprana, la elevación de la cabecera a 30 o , evitar la reanimación hídrica excesiva, la humidificación del oxígeno administrado, la higiene bronquial, los parámetros protectores de ventilación mecánica y la terapia farmacológica con broncodilatadores y micronebulizaciones.…”

Section: Discussionunclassified

Utilidad de la videolaringoscopia como predictor de extubación exitosa en pacientes con quemadura por inhalación. Reporte de casos

Amaya-Venegas¹,

Meléndez-Flores²,

Fajardo-Rivero³

2020

NCT Neumología Y Cirugía De Tórax

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www.medigraphic.com/neumología www.medigraphic.org.mx RESUMEN. Introducción: La cicatrización y remodelación después de una quemadura por inhalación aumentan el riesgo de obstrucción de la vía aérea, la mayoría de las veces se opta por garantizar la vía aérea mediante traqueostomía. La visualización del estado inicial y la evolución de la vía aérea quemada predicen las repercusiones de la lesión y podrían determinar el éxito de la extubación. La fibrobroncoscopia no permite la evaluación completa de la extensión de las lesiones en la vía aérea superior que suele ser la más afectada. El videolaringoscopio es un instrumento de fácil acceso y lo hemos utilizado para la evaluación inicial y seguimiento de las lesiones, identificando pacientes que pudieran ser extubados. Reporte de casos: Ingresaron tres pacientes a la unidad de cuidados intensivos con quemaduras graves y compromiso de la vía aérea, a quienes se realizó seguimiento semanal con videolaringoscopia como herramienta para identificar a los pacientes que podrían ser extubados. Conclusión: El seguimiento periódico y la evaluación de la progresión de las lesiones con videolaringoscopia permite evaluar la resolución del edema, la reepitelización de las úlceras y la ausencia de pérdida de tejido, que son algunos de los aspectos que derivaron en una extubación exitosa. Palabras clave: Extubación traqueal, quemaduras por inhalación, lesión por inhalación de humo, laringoscopia.

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Section: Discussionunclassified

Utilidad de la videolaringoscopia como predictor de extubación exitosa en pacientes con quemadura por inhalación. Reporte de casos

Amaya-Venegas¹,

Meléndez-Flores²,

Fajardo-Rivero³

2020

NCT Neumología Y Cirugía De Tórax

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“…During inhalational injury, the inflammatory response forms airway casts and cause V/Q mismatch, pulmonary edema and cell death, promoting airway occlusion and pulmonary dysfunction [ 1 ]. In patients with large cutaneous burns, capillary hyper-permeability occurs not only at the injured site, but also in regions distant from the injury [ 20 , 21 ] resulting in worsening of pulmonary edema. This systemic response is more severe when the thermal injury is associated with smoke inhalation [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Quantifying the impact of inhalational burns: a prospective study

et al. 2018

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BackgroundInhalational injury is a major cause of morbidity and mortality in burns patients. This study aims to analyse the clinical outcomes, complications and bacteriology of inhalational burn patients.MethodsA prospective study was done on consecutive admissions to Burn Department, Singapore General Hospital over 15 months from January 2015 to March 2016. Presence of inhalational injury, demographics, complications and outcomes was recorded. Diagnosis of inhalational injury was based on history, symptoms and nasoendoscopy. Diagnosis of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and infective complications were according to the Berlin criteria, acute kidney injury network (AKIN) classification stage 2 and above and the American Burns Association guidelines.ResultsThirty-five patients (17.3%) had inhalational burns out of 202 patients (63.4% male, 57.4% Chinese population). The average age was 43 ± 16.7 years (range 16–86), and percentage of total body surface area (%TBSA) was 12.1 ± 18.0 (range 0–88). In patients with inhalational injury, age was 38.9 ± 17.2 years and %TBSA was 30.3 ± 32.3. In patients without inhalational injury, age was 44.1 ± 12.8 years and %TBSA was 8.3 ± 9.59. Compared to patients with cutaneous injury alone, patients with inhalational burns had more surgeries (3 ± 7.07 vs 1 ± 1.54, p = 0.003), increased length of stay (21 days vs 8 days, p = 0.004) and higher in-hospital mortality rate (17.1% vs 0.6%, p < 0.001). Incidence of ARDS and AKI was 48.6% and 37.1%, respectively, compared to 0.6% and 1.2% in the patients without inhalational injury (p < 0.001). Patients with inhalational injury had increased incidence of bacteraemia (31.4% vs 2.4%, p < 0.001), pneumonia (37.1% vs 1.2%, p < 0.001) and burn wound infection (51.4% vs 25.1%, p = 0.004). Inhalational injury predicted AKI with an adjusted odds ratio (OR) of 17.43 (95% confidence interval (CI) 3.07–98.87, p < 0.001); ARDS, OR = 106.71 (95% CI 12.73–894.53, p < 0.001) and pneumonia, OR = 13.87 (95% CI 2.32–82.94, p = 0.004). Acinetobacter baumannii was the most frequently cultured bacteria in sputum, blood and tissue cultures with inhalational injury. Gram-negative bacteria were predominantly cultured from tissue in patients with inhalational injury, whereas gram-positive bacteria were predominantly cultured from tissue in patients without inhalational injury.ConclusionsInhalational injury accompanying burns significantly increases the length of stay, mortality and complications including AKI, ARDS, infection and sepsis.

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“…It is common in major (flame) burns and remains a substantial problem: Patients with inhalation injuries have a significantly higher morbidity and mortality rate than those without. 24 When an inhalation injury is suspected, the patient should be transported in a prone position. The development of acute respiratory distress syndrome (ARDS) is a major threat, and a prone position improves gas exchange in the lungs.…”

Section: Inhalation Injury and Acute Respiratory Distress Syndromementioning

confidence: 99%

An Introduction to Burn Care: The Sequel

Hermans

2024

Adv Skin Wound Care

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Care of burns, particularly those that are deep and/or extensive, requires a very specific approach from a multidisciplinary team of different types of experts. In contrast to many chronic lesions, large burns are also immediately life-threatening and have significant systemic effects that require specialized treatment as well. This article provides a high-level overview of burn care with an emphasis on these burn-specific issues and treatment. GENERAL PURPOSE To review burn care, with an emphasis on burn-specific issues and treatment. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will: 1. Select the appropriate treatment guidelines for patients who have burn injuries. 2. Identify common complications of major burns. 3. Choose the recommended pharmacologic approaches to burn care.

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Inhalation Injury

Cited by 57 publications

References 56 publications

Utilidad de la videolaringoscopia como predictor de extubación exitosa en pacientes con quemadura por inhalación. Reporte de casos

Utilidad de la videolaringoscopia como predictor de extubación exitosa en pacientes con quemadura por inhalación. Reporte de casos

Quantifying the impact of inhalational burns: a prospective study

An Introduction to Burn Care: The Sequel

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