No abstract available.
Burns* ; Humans ; Inhalation*

Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Smoke Inhalation Injury ; diagnosis ; therapy

Although the study of inhalation injury is deepening gradually, its clinical treatment is still difficult, and its mortality rate remains high due to the complicated pathophysiologic characteristics. This article reviews the recent progress in research and treatment of inhalation injury, acute lung injury, and acute respiratory distress syndrome at home and abroad, focusing on the effect of mechanical ventilation models, including the non-invasive ventilation, lung protective ventilation, liquid ventilation, high frequency ventilation, on respiratory support in early stage of inhalation injury. The effects of medications for inhalation injury are summarized, and the prospect of stem cell therapy for inhalation injury is also discussed.
Burns, Inhalation ; therapy ; Humans ; Respiration, Artificial ; methods

Adult ; Burns, Inhalation ; Humans ; Male ; Phosphorus ; poisoning

The combined effects of inhaled irritant gases and heat in burn patients can result in the development of laryngotracheal strictures. Several factors could adversely affect the development of tracheal stenosis and cause the growth of granulation tissue. Yet the current treatment options for this condition are limited because of the paucity of case reports. We report here on a case of a patient who experienced recurrent upper tracheal stenosis after an inhalation injury. She displayed repetitive symptoms of stenosis even after several laryngomicrosurgeries and resection with end-to-end anastomosis. Finally, 5 yr after the burn injury, slide tracheoplasty was successfully performed and the postoperative check-up findings and the increased airway volume seen on imaging were all satisfactory.
Burns ; Burns, Inhalation ; Constriction, Pathologic ; Gases ; Granulation Tissue ; Hot Temperature ; Humans ; Inhalation ; Tracheal Stenosis

PURPOSE: Fiber-optic bronchoscopy is widely used for early diagnosis of inhalation injury. The aim of the study was to ascertain whether a correlation could be shown between bronchoscopic and pathologic grading. METHODS: One hundred seventy patients who underwent bronchoscopy with suspicious inhalation injury were review retrospectively from January 2008 to December 2009. The patients were divided into four groups (normal, mild, moderate, severe) according to bronchoscopic and pathologic findings respectively. RESULTS: Diagnosis of an inhalation burn was confirmed in 142/170 patients, of whom upon initial assessment an inhalation trauma was suspected. Bronchoscopic grading was noted: mild (n=109), 56 ALI (51.4%), 18 ARDS (16.5%); moderate (n=31), 22 ALI (71.0%), 13 ARDS (41.9%); severe (n=2), 2 ALI (100%). Pathologic grading was noted: mild (n=131), 77 ALI (58.8%), 27 ARDS (20.6%); moderate (n=4), 2 ALI (50%), 1 ARDS (25%); severe (n=1), 1 ALI (100%). Consistency of two groups was not significant (P<0.05). CONCLUSION: Any burn patient highly suspicious for inhalation injury should receive an early bronchoscopy for diagnosis and treatment. Fiber-optic bronchoscopy is a safe and effective method for early diagnosis of inhalation injuries. The consensus of classification about inhalation injury will be developed.
Bronchoscopy ; Burns ; Burns, Inhalation ; Consensus ; Early Diagnosis ; Humans ; Inhalation ; Retrospective Studies

Ammonia is commonly used in industry and agriculture. It is also one of the most frequently accidentally spilled chemicals. Exposure to ammonia can cause severe cutaneous burn or freezing injury, ocular injury, and inhalation injury, among them inhalation injury is the most lethal one. Although the diagnosis and treatment of ammonia burns have been improved, the long-term prognosis is not satisfactory. In this article, we reviewed the literature concerning ammonia burns, in order to summarize the clinical features and treatment of such injury.
Ammonia ; adverse effects ; Burns, Chemical ; etiology ; physiopathology ; therapy ; Burns, Inhalation ; Humans ; Inhalation Exposure ; adverse effects ; Prognosis

The early pulmonary consequences of inhalation injury are well documented; however, little is known about delayed pulmonary complications following thermal inhalation injury. Although thermal injury below the vocal cords is rare because of effective heat dissipation in the upper airway, inflammatory endobronchial polyps have previously been reported as a delayed complication associated with inhalation injury. We report an extraordinary case of tracheobronchial polyps in patients with smoke inhalation injury. This report shows the delayed development and natural course of tracheobronchial polyps following thermal injury.
Bronchi ; Burns, Inhalation ; Hot Temperature ; Humans ; Inhalation* ; Polyps* ; Smoke Inhalation Injury ; Trachea ; Vocal Cords

PURPOSE: This study was conducted to assess the appropriateness of emergency department-based triage for determining whether to transfer of burn patients to a burn care specialty center. METHODS: Eligible subjects were enrolled from the EDbased injury surveillance registry from April 2006 to March 2007 in a regional emergency center, which logs more than 42,000 patients annually. To assess the appropriateness of emergency department-based triage for determining whether to transfer patients to a burn center, we used the transfer guidelines recommended by the American Burn Association as the gold standard. Under-triage (defined as non-transfer of a victim who should have been transferred) and the over-triage (defined as transfer of a victim who should not have been transferred) rates were calculated. RESULTS: The total number of burn injury victims was 144 and the male-female ratio was 1:1.15. The mean age was 25.5+/-20.9 years. The numbers of flame, electrical, chemical, inhalation, and other burn injuries were 133 (92.4%), 2 (1.4%), 6 (4.1%), 1 (0.7%), and 2 (1.4%), respectively. Of these 144 patients, 25 (17.4%) were transferred to the ED of a burn center after triage and primary management. The others were discharged and followed up at local clinics. The numbers of major and moderate burns that were indicated for transfer to the burn center were 33 (22.9%) and 3 (2.1%), respectively. The rates of under- and over-triage were 14.6% and 6.9%. CONCLUSION: The proportion of inappropriate disposition of burn injury in a regional emergency center was high (21.5%). Recommended guidelines for triage of burn injuries should be applied more strictly.
Burn Units ; Burns* ; Emergencies* ; Emergency Service, Hospital ; Humans ; Inhalation ; Triage*

BACKGROUND AND OBJECTIVES: Inhalation injuries can produce a wide spectrum of negative clinical effects. Respiratory failure remains one of the leading causes of death in burned patients with inhalation injury. Despite advances in understanding of inhalation injury, few studies have focused on histopathologic findings of tracheal mucosa. The purpose of this study is to investigate histopathologic changes of tracheal mucosa in burned patients with inhalation injury. SUBJECTS AND METHOD: Tracheotomy was performed on 31 patients who was admitted to the Hospital center from May 2005 to March 2006. Thirty-one patients were divided into two groups : patients with inhalation injury (group I)(n=16), patients without inhalation injury (group II)(n=15). Tracheal mucosa were taken out during the tracheotomy. The tracheal mucosa were read blindly by one pathologist. RESULTS: Histopathologic examination showed the following finding in the tracheal mucosa of all patients in the group I : epithelial ulceration. Different findings were observed in the group I as time passed by after inhalation injury, such as interstitial edema, inflammatory cell infiltration, capillary dilatation, and increased fibrosis. No abnormal findings were observed in the tracheal mucosa in the group II. CONCLUSION: Inhalation injuries cause histopathologic damages to tracheal mucosa. The different histopathologic findings of tracheal mucosa that take place in time following inhalation injuries suggest to process an inflammatory reaction. The study in related to clinical features should be needed due to tracheal mucosa injury may produce respiratory complications.
Burns* ; Burns, Inhalation ; Capillaries ; Cause of Death ; Dilatation ; Edema ; Fibrosis ; Humans ; Inhalation* ; Mucous Membrane* ; Respiratory Insufficiency ; Trachea ; Tracheotomy ; Ulcer