Respiratory complications in burned patients: Pathogenesis and spectrum of inhalation injury

Haponik, Edward F.; Summer, Warren R.

doi:10.1016/0883-9441(87)90121-3

Cited by 24 publications

(8 citation statements)

References 163 publications

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“…[ 17 18 ] Failure to clear particulate material due to impaired ciliary activity perpetuates the injury process. [ 19 ] One of the early changes of inhalational injury is the increase of pulmonary vascular resistance, possibly chemically mediated, leading to an increase of pulmonary capillary pressure and fluid leak. [ 20 21 ] Neutrophils adhere to the alveolar capillary membrane leading to an outpouring of protease and oxidants, resulting in aggravation of lung injury.…”

Section: Discussionmentioning

confidence: 99%

Isolated inhalational injury: Clinical course and outcomes in a multidisciplinary intensive care unit

Chacko¹,

Jahan²,

Brar³

et al. 2012

Indian Journal of Critical Care Medicine

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Background and Aims:Although smoke inhalation is well known to cause acute lung injury, there are few reports in literature that study the evolution, clinical course and outcomes of isolated inhalational lung injury in a modern intensive care setting. A major fire disaster provided us the opportunity to study victims of isolated inhalational injury admitted to our Multidisciplinary Intensive Care Unit (MICU).Materials and Methods:We studied the clinical course, ICU and hospital outcomes of 13 victims of a fire disaster who required mechanical ventilation for isolated inhalational lung injury. All patients were followed up at regular intervals, and their functional status was assessed at 8 months after hospital discharge.Results:The Lung Injury Scores (LIS) worsened to reach a nadir on Day 3 of injury. There was a significant correlation between the LIS on Day 3 and duration of mechanical ventilation (r = 0.8; P = 0.003), ICU (r = 0.8; P = 0.002) and hospital (r = 0.6; P = 0.02) days. Late-onset airway complications were encountered in four patients. Three of them required long-term artificial airways – two with a tracheostomy while the third patient required surgical insertion of a “T” tube. Persistent problems with phonation occurred in two patients. At 8 months postdischarge, all patients were independent with activities of daily living; all were back to work, except for two who continued to need artificial airways.Conclusions:Inhalational lung injury progresses over the first few days and is worst after 72 h. Late-onset airway complications may manifest after several weeks and require repeated intervention.

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Section: Discussionmentioning

confidence: 99%

Isolated inhalational injury: Clinical course and outcomes in a multidisciplinary intensive care unit

Chacko¹,

Jahan²,

Brar³

et al. 2012

Indian Journal of Critical Care Medicine

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“…In both the cases there is inflammation and damage of respiratory tract mucosa, which if not treated properly leads to secondary damage and infection leading to involvement of lower respiratory tract and alveolus. [20][21][22][23] Infection and immune profi le in burns The marked decrease in hypovolemic shock and acute renal failure as causes of death due to proper resuscitation and effective fluid management has led to infection as the major cause of concern in burns. [24] Infection in burns is proportionate to the fraction of body surface injured.…”

Section: Primary Respiratory Tract Injury In Burnmentioning

confidence: 99%

Burn wound: How it differs from other wounds?

Tiwari

2012

Indian J Plast Surg

264

180

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Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.

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“…He suffered multiple burn injuries, which covered a limited body surface, with inclusion of the skin around mouth and nose. The occurrence of fire in closed settings, with heat and burns involving the face, are all well-known risk factors for inhalation injury [15,16]. The victim underestimated the importance of his injuries and decided not to go to the hospital.…”

Section: Discussionmentioning

confidence: 99%

Delayed asphyxia due to inhalation injury

Fracasso

Schmeling²

2010

Int J Legal Med

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We report the case of a 53-year-old man who was found dead in his apartment 2 days after a little fire during which he had suffered from second to third degree burns at 2% of the body surface, also involving the skin around the mouth and the nose. At autopsy, severe acute emphysema and mucopurulent obstructive laryngotracheobronchitis were observed. The histology showed desquamative loss of the respiratory epithelium up to the middle bronchi; the bronchial lumen was filled with clumps of mucopurulent secretions mixed with necrotic epithelial cells. The cause of death was a delayed asphyxia due to inhalation injury.

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Respiratory complications in burned patients: Pathogenesis and spectrum of inhalation injury

Cited by 24 publications

References 163 publications

Isolated inhalational injury: Clinical course and outcomes in a multidisciplinary intensive care unit

Isolated inhalational injury: Clinical course and outcomes in a multidisciplinary intensive care unit

Burn wound: How it differs from other wounds?

Delayed asphyxia due to inhalation injury

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