Mlcak RP, Suman OE, Herndon DN, et al.
Burns : journal of the International Society for Burn Injuries. Date of publication 2007 Feb 1;volume 33(1):2-13.
1. Burns. 2007 Feb;33(1):2-13.
Respiratory management of inhalation injury.
Mlcak RP(1), Suman OE, Herndon DN.
Author information:
(1)Respiratory Care Department, Shriners Hospital for Children, Galveston, TX,
USA. rmlcak@utmb.edu
Advances in the care of patients with major burns have led to a reduction in
mortality and a change in the cause of their death. Burn shock, which accounted
for almost 20 percent of burn deaths in the 1930s and 1940s, is now treated with
early, vigorous fluid resuscitation and is only rarely a cause of death. Burn
wound sepsis, which emerged as the primary cause of mortality once burn shock
decreased in importance, has been brought under control with the use of topical
antibiotics and aggressive surgical debridement. Inhalation injury has now become
the most frequent cause of death in burn patients. Although mortality from smoke
inhalation alone is low (0-11 percent), smoke inhalation in combination with
cutaneous burns is fatal in 30 to 90 percent of patients. It has been recently
reported that the presence of inhalation injury increases burn mortality by 20
percent and that inhalation injury predisposes to pneumonia. Pneumonia has been
shown to independently increase burn mortality by 40 percent, and the combination
of inhalation injury and pneumonia leads to a 60 percent increase in deaths.
Children and the elderly are especially prone to pneumonia due to a limited
physiologic reserve. It is imperative that a well organized, protocol driven
approach to respiratory care of inhalation injury be utilized so that
improvements can be made and the morbidity and mortality associated with
inhalation injury be reduced.
DOI: 10.1016/j.burns.2006.07.007
PMID: 17223484 [Indexed for MEDLINE]
