The pathophysiology of inhalation injury

Smoke inhalation injury is a detrimental complication of burn patients leading to high mortality. As a consequence of smoke inhalation, acute lung injury/acute respiratory distress syndrome aggravates morbidity in these patients, requiring extended ventilator support, longer intensive care unit or hospital stay, and high cost. The acute pathophysiology of smoke inhalation injury has been relatively well studied, and a generally accepted standard of care is available for use in burn centers and hospitals worldwide. However, long-term pathologic changes in pulmonary function in burn survivors remain incompletely understood. Future studies should also focus on the pathophysiology of nonpulmonary multiorgan injuries/dysfunctions in both acute and chronic phases. This chapter summarizes the epidemiology and acute pathophysiology of both airway and pulmonary parenchymal damage after smoke inhalation. It also describes toxic smoke compounds with detailed treatment recommendations.