Objective To investigate effects of the complex therapy on severe inhalation injury. Methods The cases with inhalation injury and acute respiratory failure (ARF) of 4172 consecutive burn patients from Jan. 2000 to Feb. 2003 in our institute were studied retrospectively. Results 30 of the 128 patients with inhalation injury occurred acute ARF. 48 hours after the exogenous pulmonary surfactant (PS) was used to treat 6 cases with uncomplicated ARF, pulmonary function obviously ameliorated as compared with routine therapy. PaO 2 /FiO 2 rose from 239?33 mmHg to 317?28 mmHg(P