Isolated inhalational injury: Clinical course and outcomes in a multidisciplinary intensive care unit
Open Access
- 1 April 2012
- journal article
- research article
- Published by Jaypee Brothers Medical Publishing in Indian Journal of Critical Care Medicine
- Vol. 16 (2), 93-99
- https://doi.org/10.4103/0972-5229.99120
Abstract
Background and Aims: Although smoke inhalation is well known to cause acute lung injury, there are few reports in literature that study the evolution, clinical course and outcomes of isolated inhalational lung injury in a modern intensive care setting. A major fire disaster provided us the opportunity to study victims of isolated inhalational injury admitted to our Multidisciplinary Intensive Care Unit (MICU). Materials and Methods: We studied the clinical course, ICU and hospital outcomes of 13 victims of a fire disaster who required mechanical ventilation for isolated inhalational lung injury. All patients were followed up at regular intervals, and their functional status was assessed at 8 months after hospital discharge. Results: The Lung Injury Scores (LIS) worsened to reach a nadir on Day 3 of injury. There was a significant correlation between the LIS on Day 3 and duration of mechanical ventilation (r = 0.8; P = 0.003), ICU (r = 0.8; P = 0.002) and hospital (r = 0.6; P = 0.02) days. Late-onset airway complications were encountered in four patients. Three of them required long-term artificial airways - two with a tracheostomy while the third patient required surgical insertion of a "T" tube. Persistent problems with phonation occurred in two patients. At 8 months postdischarge, all patients were independent with activities of daily living; all were back to work, except for two who continued to need artificial airways. Conclusions: Inhalational lung injury progresses over the first few days and is worst after 72 h. Late-onset airway complications may manifest after several weeks and require repeated intervention.Keywords
This publication has 38 references indexed in Scilit:
- Respiratory Complications in BurnsClinical Pulmonary Medicine, 2009
- Prehospital Administration of Hydroxocobalamin for Smoke Inhalation-Associated Cyanide Poisoning: 8 Years of Experience in the Paris Fire BrigadeClinical Toxicology, 2006
- Role of hypoxic pulmonary vasoconstriction in pulmonary gas exchange and blood flow distributionIntensive Care Medicine, 1994
- Tracheostomies in Burn PatientsAnnals of Surgery, 1989
- Smoke Inhalation and Airway Management at a Regional Burn UnitJournal of Burn Care & Rehabilitation, 1989
- Smoke inhalationBurns, 1988
- Is Tracheostomy Warranted in the Burn Patient? Indications and ComplicationsJournal of Burn Care & Rehabilitation, 1986
- BurnsThe New England Journal of Medicine, 1985
- Laryngotracheal injury due to endotracheal intubationCritical Care Medicine, 1983
- A Correlation of Experimental and Clinical DataAnnals of Surgery, 1977