Blood gas studies in dogs with severe steam inhalation injury

Inhalation injury in southwest China--the evolution of care

AIM

This study aims to review the changes in management of inhalation injury and the associated reduction in mortality over the past 2 decades.

METHODS

The records of burn patients with inhalation injury hospitalised in our institute from 1986 to 2005 were retrospectively analysed. The incidence of inhalation injury and the associated mortality were analysed. Meanwhile, the relationship of inhalation injury with age, total burn area, tracheostomy intubation and mechanical ventilation were studied.

RESULTS

The incidence of inhalation injury was 8.01% in the total 10 608 hospitalised burn patients during the 20 years surveyed. Inhalation injury was always associated with large-sized burn and was more common in adults. The incidence of tracheostomy and mechanical ventilation increased from 39.46 and 30.28% in the period from 1986 to 1995 to 70.12 and 39.74% from 1996 to 2005, respectively. The overall mortality of inhalation-injured burn patients was 15.88% compared with 0.82% of the non-inhalation group. The mortality of the burn patients with inhalation injury dropped from 25.29% during the first 10 years to 11.71% during the second decade (p<0.01). Mortality secondary to inhalation injury as the lead cause decreased from 14.56 to 6.29% (p<0.01).

CONCLUSION

The care of inhalation injury has made significant progress over the past 2 decades. The early diagnosis of inhalation injury, early airway control and pulmonary function assistance with mechanical ventilation contribute to the reduction of mortality.

Smoke inhalation

An attempt has been made to review the characteristics of fire and smoke and the epidemiology of smoke inhalation to identify some of the many variables which interact to control the severity of the injury. An experimental model appropriate to study the pulmonary injury of smoke victims who survive to enter the health care system is described. Experiments which define how smoke damages the lung are reviewed in an effort to explain why the smoke-damaged lung is vulnerable to additional stress and why those with an injured lung and a burn have such a high mortality rate.