The Findings of Pulmonary Function Test in Patients with Inhalation Injury.
10.4046/trd.2006.60.6.653
- Author:
Jong Yeop KIM
1
;
Cheol Hong KIM
;
Hyun Won SHIN
;
Young Je CHAE
;
Chul Young CHOI
;
Tae Rim SHIN
;
Yong Bum PARK
;
Jae Young LEE
;
Joon Woo BAHN
;
Sang Myeon PARK
;
Dong Gyu KIM
;
Myung Goo LEE
;
In Gyu HYUN
;
Ki Suck JUNG
Author Information
1. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. ighyun@hallym.ac.kr
- Publication Type:Original Article
- Keywords:
Burn;
Inhalation;
Pulmonary function test
- MeSH:
Bronchoscopy;
Burns;
Cicatrix;
Follow-Up Studies;
Humans;
Inflammation;
Inhalation*;
Intubation, Intratracheal;
Lung;
Pneumonia;
Prospective Studies;
Respiration, Artificial;
Respiratory Function Tests*;
Spirometry;
Thoracic Wall
- From:Tuberculosis and Respiratory Diseases
2006;60(6):653-662
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. METHODS: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. RESULTS: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial PaO2/FiO2ratio and COHb were 286.4+/-129.6 mmHg and 7.8+/-6.6 %. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. CONCLUSIONS: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.
