Respiratory Burns: A Clinical Review

Robert      J. Boots; Joel      M. Dulhunty; Jennifer      Paratz; Jeffrey      Lipman

Abstract

Respiratory injury in burns occurs as a result of thermal, chemical or systemic inflammatory effects. Inhalation injury occurs in up to 40% of patients admitted to hospital following burns. Three stages in the evolution of inhalation injury are described. The early phase (first 48 hours) is associated with pulmonary edema, acute respiratory distress syndrome, airway obstruction, and carbon monoxide and cyanide toxicity. During the middle phase (days to weeks), pneumonia and venous thromboembolism may develop. Late sequelae (months to years post burn injury), while uncommon, include reactive airways dysfunction syndrome, bronchiolitis obliterans and tracheal stenosis. Specific interventions early in the management of inhalation injury are necessary to prevent worsening the injury and minimizing late sequelae.

Keywords: Acute respiratory distress syndrome (ARDS), burns, inhalation burns, pneumonia, reactive airways dysfunction syndrome (RADS), smoke inhalation injury, Acute respiratory distress syndrome, (ARDS), reactive airways dysfunction syndrome, RADS, pneumothorax, fat embolism, Respiratory failure, dyspnea, stridor, drooling, dysphagia, chest tightness, laryngoscopy, carboxyhemoglobin, EDTA, Bronchodilator therapy, Chest Wall Restriction, hypotension, Pulmonary Edema, Bronchospasm, ETT, HFOV, HFPV, ECMO, Venous Thromboembolism, Sinusitis, Haemophilus influenzae, Streptococcus pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Vocal Cord Paralysis, Tracheostomy, Inhaled Heparin, Antithrombin, Tracheal Stenosis