Isolated smoke inhalation injuries: Acute respiratory dysfunction, clinical outcomes, and short-term evolution of pulmonary functions with the effects of steroids

Authors
Seung Ick ChaChang Ho KimJae Hee LeeJae Yong ParkTae Hoon JungWon Il ChoiSeung Bum HanYoung June JeonKyeong Cheol ShinJin Hong ChungKwan Ho LeeYeon Jae KimByeong Ki Lee
Department
Dept. of Internal Medicine (내과학)
Issue Date
2007
Citation
Burns, Vol.33(2) : 200-208, 2007
ISSN
0305-4179
Abstract
Relatively few reports exist regarding isolated smoke inhalation injuries in human patients. In this study, we describe the acute manifestations and short-term evolution of respiratory injuries after isolated smoke inhalation in victims of fires. Ninety-six patients admitted as the result of a subway fire were examined for acute respiratory dysfunction with clinical outcomes. Some of the survivors suffering from less severe injuries were evaluated for changes in pulmonary function over time, with the effects of steroid treatment. In 13 patients (14%), immediate respiratory failure resulted from ventilatory insufficiency, which was induced principally by mechanical airway obstruction, and manifested as significantly lowered pH and higher PaCO2 levels than in the patients requiring no mechanical ventilation. Toilet bronchoscopy allowed for early liberation from mechanical ventilation. Along with the death of 4 patients (4%), vocal cord and tracheal stenosis were noted in 5 patients and 1 patient, respectively, among 17 patients for whom endotracheal intubation was required. Pulmonary functions improved significantly after 3 months, with no further changes being observed within the subsequent 3 months. Steroid therapy resulted in no additional improvements in the pulmonary functions of these patients. In patients with isolated smoke inhalation injuries, immediate ventilatory insufficiency resulting from mechanical airway obstruction should be watched for, and managed via toilet bronchoscopy. Vigilance is required to avoid airway complications after endotracheal intubation. The improvement of pulmonary functions progressed primarily within the first 3 months, whereas shortcourse steroid therapy exerted no influence on the eventual recovery of pulmonary functions in the less severe cases. Keywords: Smoke inhalation, Pulmonary function, Steroid, Vocal cord stenosis, Tracheal stenosis,
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35274
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
최원일; 한승범; 전영준
Full Text
http://lps3.www.sciencedirect.com.proxy.dsmc.or.kr/science/article/pii/S0305417906002221?via%3Dihub
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