Inhalation injury in burned patients: effects and treatment

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

Research output: Contribution to journalArticle

91 Citations (Scopus)

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 - 1988

Fingerprint

Inhalation
Wounds and Injuries
Lung
Cardiac Output
Smoke Inhalation Injury
Therapeutics
Poisons
Capillary Permeability
Pulmonary Edema
Microcirculation
Burns
Intubation
Resuscitation
Neutrophils
Neck
Hot Temperature
Steroids
Pathology
Anti-Bacterial Agents
Mortality

ASJC Scopus subject areas

  • Emergency Medicine
  • Surgery

Cite this

Herndon, D., 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

Inhalation injury in burned patients : effects and treatment. / Herndon, David; Barrow, R. E.; Linares, H. A.; Rutan, R. L.; Prien, T.; Traber, Lillian D.; Traber, D. L.

In: Burns, Vol. 14, No. 5, 1988, p. 349-356.

Research output: Contribution to journalArticle

Herndon, D, Barrow, RE, Linares, HA, Rutan, RL, Prien, T, Traber, LD & Traber, DL 1988, 'Inhalation injury in burned patients: effects and treatment', Burns, vol. 14, no. 5, pp. 349-356. https://doi.org/10.1016/0305-4179(88)90002-2
Herndon D, Barrow RE, Linares HA, Rutan RL, Prien T, Traber LD et al. Inhalation injury in burned patients: effects and treatment. Burns. 1988;14(5):349-356. https://doi.org/10.1016/0305-4179(88)90002-2
Herndon, David ; Barrow, R. E. ; Linares, H. A. ; Rutan, R. L. ; Prien, T. ; Traber, Lillian D. ; Traber, D. L. / Inhalation injury in burned patients : effects and treatment. In: Burns. 1988 ; Vol. 14, No. 5. pp. 349-356.
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