Pathophysiology, management and treatment of smoke inhalation injury

Sebastian Rehberg, Marc O. Maybauer, Perenlei Enkhbaatar, Dirk M. Maybauer, Yusuke Yamamoto, Daniel L. Traber

Research output: Contribution to journalReview articlepeer-review

102 Scopus citations


Smoke inhalation injury continues to increase morbidity and mortality in burn patients in both the third world and industrialized countries. The lack of uniform criteria for the diagnosis and definition of smoke inhalation injury contributes to the fact that, despite extensive research, mortality rates have changed little in recent decades. The formation of reactive oxygen and nitrogen species, as well as the procoagulant and antifibrinolytic imbalance of alveolar homeostasis, all play a central role in the pathogenesis of smoke inhalation injury. Further hallmarks include massive airway obstruction owing to cast formation, bronchospasm, the increase in bronchial circulation and transvascular fluid flux. Therefore, anticoagulants, antioxidants and bronchodilators, especially when administered as an aerosol, represent the most promising treatment strategies. The purpose of this review article is to provide an overview of the pathophysiological changes, management and treatment options of smoke inhalation injury based on the current literature.

Original languageEnglish (US)
Pages (from-to)283-297
Number of pages15
JournalExpert Review of Respiratory Medicine
Issue number3
StatePublished - 2009


  • Acute lung injury
  • Anticoagulants
  • Antioxidants
  • Carbon monoxide
  • Cyanide
  • Nitric oxide
  • Reactive oxygen species
  • β -agonists

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health


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