Inhalation injury in burned patients: effects and treatment

D. N. Herndon, R. E. Barrow, H. A. Linares, R. L. Rutan, T. Prien, Lillian D. Traber, D. L. Traber

Research output: Contribution to journalArticle

92 Scopus citations

Abstract

Pulmonary pathology in major thermal injury is found in 30-80 per cent of burn fatalities. The incidence and mortality from inhalation injury increases both with age and increasing burn size. Toxic smoke inhalation injury, characterized by increased lung microvascular permeability, is attenuated by increasing cardiac output to normal levels, indicating that fluid restriction after inhalation injury may lead to excessive lung fluid formation and hypoxia. Fluid administration of approximately 2ml/kg/% area burned above the calculated resuscitation volume is required following an inhalation injury to provide adequate support for the systemic circulation and maintain cardiac output at normal levels. This additional volume does not contribute to the development of pulmonary oedema, but may decrease its formation by increasing shear forces thus reducing polymorphonuclear leucocyte deposition in the pulmonary microcirculation. Nasotracheal intubation is preferred when airway integrity is compromised by inhalation injury. The advantages are non-operative placement, ease of discontinuation, minimal bacterial contamination and leaving neck burns undisturbed. The administration of the appropriate antibiotics for documented infection is recommended, while steroids have been shown to be of no benefit.

Original languageEnglish (US)
Pages (from-to)349-356
Number of pages8
JournalBurns
Volume14
Issue number5
DOIs
StatePublished - Oct 1988

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Inhalation injury in burned patients: effects and treatment'. Together they form a unique fingerprint.

  • Cite this

    Herndon, D. N., Barrow, R. E., Linares, H. A., Rutan, R. L., Prien, T., Traber, L. D., & Traber, D. L. (1988). Inhalation injury in burned patients: effects and treatment. Burns, 14(5), 349-356. https://doi.org/10.1016/0305-4179(88)90002-2