Respiratory Insufficiency and Its Classification in Patients with Severe Burns
- VernacularTitle:严重烧伤病人肺脏损害及其类型探讨
- Author:
Yuesheng HUANG
- Publication Type:Journal Article
- Keywords:
ever brespiratory failure;
inhalation injury
- From:Journal of Third Military Medical University
1988;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Blood gases and pathological changes of lung tissues from patients dying of respiratory failure were observed. The results demonstrated that hypoxemia, hypocapnia, enlarging of A-DO2 and metabolic acidosis occurred soon after severe burns. The severity of falling of PaO2 was positively accorded with burn size (TBSA) . In patients complicated with moderate and severe inhalation injury, severe shock and systemic infections, the reduction of PaO2 was much more pronounced than in those without the above mentioned complications. The failed lung tissues showed congestion, hemorrhage, edema and thrombosis. These findings suggested that besides the severity of burns itself, inhalation injury, severe shock and systemic infections were the main etiological factors invoking postburn lung damage, and the inhalation injury ranked the first. Of the 57 patients 16 developed respiratory failure.The postburn respiratory failure could be classified into three patterns: 1 ).Early pattern, 6 cases (37.5%) , occurring during shock stage. Severe inhalation injury was the main cause) 2). Delayed pattern, 8 cases (50.0%) , developing during acute infection stage of the burn course. Clinical course of this pattern simulated to that of ARDS and the main etiological factors included severe shock and early systemic infections; and 3) .Late pattern, 2 cases (12.5%), occurring during wound healing and rehabilitation ages. The reasons chiefly included severe hypoproteinemia, malnutrition, infect and pulmonary embolism due to thrombosis of inferior vena cera or feora vein.
