| Pulmonary injury in burned patients. | |
| | |
MedLine Citation:
|
PMID: 3916776 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
1. With improvements in treatment of burn shock and wound sepsis, inhalation injury has emerged as the number one cause of fatality in the burn patient; it accounts for 20 to 84 per cent of burn mortality. 2. Only steam is capable of inflicting direct thermal damage; most injury is caused by incomplete products of combustion, the most important being aldehydes. 3. More accurate diagnostic techniques, including fiberoptic bronchoscopy and 133Xe scanning, have been added to the traditional clinical signs of inhalation injury, such as facial burns, singed nasal vibrissae, and closed space injury, and have led to a new estimation of a 30 per cent incidence among patients with major burns. 4. Patients with inhalation injury typically pass through three stages, those of acute pulmonary insufficiency, pulmonary edema, and bronchopneumonia. 5. The major early pathophysiologic changes seen in the lungs of burned patients related to edema. With inhalation injury this is probably mediated by the products of activated neutrophils. Later changes are the result of the reduction of surfactant and thus lung compliance. 6. Treatment consists of intubation at the first hint of respiratory distress; the issue of tracheostomy versus endotracheal intubation has not been scientifically resolved, but most centers employ prolonged nasotracheal intubation. Prophylactic antibiotics or steroids are not of benefit. Further care is only supportive and includes CPAP, PEEP, vigorous pulmonary toilet, humidification of inspired air, and antibiotics for documented infection. 7. Further advances await the development of pharmacologic methods of affecting the lung's response to injury, which includes altered capillary permeability and decreased immune function. |
| | |
Authors:
|
D N Herndon; P B Thompson; D L Traber |
Related Documents
:
|
3289426 - Alkaline chemical burn to the face requiring full-thickness skin grafting. 2648426 - Longitudinal assessment of breast development in adolescent female patients with burns ... 18538666 - High c5a levels are associated with increased mortality in sepsis patients--no enhancin... 14960966 - Beta-blocker use is associated with improved outcomes in adult burn patients. 7092616 - Dystonia musculorum deformans: implications of therapeutic response to levodopa and car... 8306386 - Gout: an experience from zimbabwe. |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Critical care clinics Volume: 1 ISSN: 0749-0704 ISO Abbreviation: Crit Care Clin Publication Date: 1985 Mar |
Date Detail:
|
Created Date: 1988-09-22 Completed Date: 1988-09-22 Revised Date: 2005-11-16 |
Medline Journal Info:
|
Nlm Unique ID: 8507720 Medline TA: Crit Care Clin Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 79-96 Citation Subset: IM |
Affiliation:
|
Shriners Burns Institute, Galveston, Texas. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Burns, Inhalation*
/
diagnosis,
mortality,
physiopathology,
therapy Humans |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Hyperbaric oxygen in the treatment of burns.
Next Document: Metabolism and nutrition in the thermally injured patient.