Document Detail


Factors that predict the need for intubation in patients with smoke inhalation injury.
MedLine Citation:
PMID:  16696366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early identification of smoke inhalation patients who will require intubation is crucial. We conducted a retrospective chart review to identify predictors of respiratory distress in patients who present with smoke inhalation injury. Our study involved 41 patients who had been treated in the emergency room at a regional burn center. Eight of these patients required intubation. Intubation was positively correlated with physical examination findings of soot in the oral cavity (p < 0.001), facial burns (p = 0.025), and body burns (p = 0.025). The need for intubation was also predicted by fiberoptic laryngoscopic findings of edema of either the true vocal folds (p < 0.001) or the false vocal folds (p < 0.01). No statistically significant correlation was found between intubation and any of the classic symptoms of smoke inhalation: stridor, hoarseness, drooling, and dysphagia (all p = 1.0). Also, multivariate analysis revealed that facial burns correlated significantly with edema of the true vocal folds (p = 0.01) and body burns correlated significantly with edema of both the true (p = 0.047) and false (p = 0.003) vocal folds. We conclude that patients with soot in the oral cavity, facial burns, and/or body burns should be monitored closely because these findings indicate a higher likelihood of laryngeal edema and the need for intubation.
Authors:
Dilip D Madnani; Natalie P Steele; Egbert de Vries
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ear, nose, & throat journal     Volume:  85     ISSN:  0145-5613     ISO Abbreviation:  Ear Nose Throat J     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-05-15     Completed Date:  2006-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7701817     Medline TA:  Ear Nose Throat J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  278-80     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Jacobi Medical Center, Albert Einstein College of Medicine, New York City, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Carbon
Chi-Square Distribution
Child
Child, Preschool
Female
Humans
Intubation, Intratracheal*
Laryngeal Edema / diagnosis,  etiology*,  therapy*
Male
Middle Aged
Retrospective Studies
Risk Factors
Smoke Inhalation Injury / complications*,  therapy*
Vocal Cords / pathology
Chemical
Reg. No./Substance:
7440-44-0/Carbon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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