Respiratory management of inhalation injury

Mlcak, Ronald P.; Suman, Oscar E.; Herndon, David N.

doi:10.1016/j.burns.2006.07.007

Cited by 195 publications

(161 citation statements)

References 51 publications

Supporting

Mentioning

140

Contrasting

Unclassified

Order By: Relevance

“…The reduction and inactivation of pulmonary surfactant have been reported as a result of this aggression in the airways [30]. Additionally, we have decreased mucociliary clearance and subsequent increased vulnerability to infection sites and bronchospasm.…”

Section: Discussionmentioning

confidence: 69%

Factors associated with survival of burned patients

et al. 2015

View full text Add to dashboard Cite

Background: It is scarce in the literature studies regarding treatment and objective analysis of the survival chances of burned patients. Some investigations indicates the need for obtaining specific data to the population studied and characteristics such as social condition and nutritional status are suggested to be relevant to the patient's evolution. We aimed to describe the mortality of a Treatment Center Burn Unit (BU) in Brazil. Methods:We analyzed 76 burned victims hospitalized with a fatal outcome in the General Hospital of São Matheus in 10 years (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009). The following collected data were investigated were: age, sex, period of permanence, body surface burned (BSB), degree of burns, the causal agent, inhalation injury, nature of the event, clinical complications, mortality and survival rates. Results:We observed predominantly male and the median age was 44 years old. The highest incidence was on June. The mean body surface area burned was 40%, and upper limbs, the most affected region. The causative agents involved were more flammable agents and fire. Pulmonary infection was the most frequent clinical complication. The mortality found in this center was 4.9%. The subgroup of suicide were predominantly female and the mortality rate was 22.44%. When studying survival rate, patients with inhalation injury and trauma were associated with shorter survival. Patients with sepsis remained alive for longer. Conclusion:The clinical, epidemiological and survival of patients with burns, enables the design of peculiar characteristics of this trauma in the studied area, thus, from these data, charts be established treatment and prognostic estimates, and assist in developing preventive public health policy more effective.

show abstract

Section: Discussionmentioning

confidence: 69%

Factors associated with survival of burned patients

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The mortality of inhalation injury without cutaneous burn injury is approximately 10%, whereas with cutaneous burn injury, the mortality increases more than twice 1, 2. Inhalation injury increases fluid requirements3 and the incidence of pneumonia 4.…”

Section: Introductionmentioning

confidence: 99%

Indications of early intubation for patients with inhalation injury

Onishi

Osuka

Kuroki

et al. 2017

Acute Medicine & Surgery

View full text Add to dashboard Cite

AimFor patients with inhalation injury, the indications for early intubation are diverse. The purpose of this study was to identify the most reliable symptoms, physical findings, and medical examinations with which to determine the indications for early intubation in patients with inhalation injury.MethodsWe retrospectively collected patient data from medical records. Collected data included age, sex, burn size, symptoms, physical findings, carboxyhemoglobin levels (COHb), and bronchial wall thickness (BWT) determined from chest computed tomography images. We analyzed the relationships between these findings and the early intubation. We performed fiberoptic bronchoscopy in all patients, and analyzed the relationships between bronchoscopic severity and other findings.ResultsOf the 205 patients, 80 patients were diagnosed as having inhalation injury, and 34 patients were intubated. Burn size, facial burns, neck burns, use of accessory respiratory muscles, and COHb seemed to be related with intubation, whereas singed nasal hair was not. If the patients suffered ≥27% total body surface area burn and BWT ≥3.5 mm, the positive predictive value for early intubation was 1.00. If the patients suffered smaller cutaneous burn without neck burn, and their COHb <4.0%, the negative predictive value for early intubation was 0.97. Fiberoptic bronchoscopy findings from above the glottis were mainly related with patients’ symptoms. Findings from below the glottis were mainly related with BWT and COHb.ConclusionsPatients’ symptoms, especially use of accessory respiratory muscles, are reliable, and BWT and COHb are also useful tools, for determining the indication for early intubation.

show abstract

“…However these patients had a 12 % mortality rate compared to a 3 % mortality rate for patients burned in other types of fi res [ 4 ]. This difference in mortality is attributed to the prevalence of inhalation injury in residential fi res [ 5 ].…”

Section: Introductionmentioning

confidence: 94%

“…Infection is a common problem in burn units, and it is thought that up to 75 % of deaths occurring after the initial resuscitation period are attributable to infectious complications [ 5 ]. Burn injuries cause signifi cant immunological stress , and wounds are at risk of bacterial infection due to breakdown of the skin barrier as well as to alterations to innate and acquired immunity [ 5 , 49 ].…”

Section: Patients and Complicationsmentioning

confidence: 99%