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. 2011 Jun 30;24(2):82-8.

Inhalation injury as a prognostic factor for mortality in burn patients

R H El-Helbawy  1 , F M Ghareeb
Affiliations

Inhalation injury as a prognostic factor for mortality in burn patients

R H El-Helbawy et al. Ann Burns Fire Disasters. .

Abstract
in English, French

Inhalation injury greatly increases the incidence of respiratory failure and acute respiratory distress syndrome. It is also the cause of most early deaths in burn victims. The aim of this research is to study the incidence, early diagnosis, complications, and management of inhalation injury and to discuss the relationship between inhalation injury and death in burn patients. The study included 130 burn patients (61 male and 69 female) with inhalation injury admitted to Menoufiya University Hospital Burn Center & Chest Department (Egypt) from January 2008 to January 2010. It was found that the presence of inhalation injury, increasing burn size, and advancing age were all associated with increased mortality (p < 0.01). The incidence of inhalation injury was 46.3% (the 130 patients came from a total number of 281 burn victims). The overall mortality rate among patients with inhalation injury was 41.5% (54/130) compared with 7.2% (11/151) among patients without inhalation injury. These statistics clearly indicate that inhalation injury was an important factor for predicting burn patient mortality. Approximately 80% of fire-related deaths are due not to the airway burn injury itself but to the inhalation of toxic products, especially carbon monoxide and hydrogen cyanide gases. Inhalation injury is generally caused by thermal burns, and is mostly confined to the upper airways. Major airway, pulmonary, and systemic complications occur after inhalation injury, and this increases the incidence of mortality among burn patients.

Les lésions causées par l’inhalation sont responsables d’un incrément élevé de la fréquence de l’insuffisance respiratoire et du syndrome de détresse respiratoire aiguë. EIles sont également la cause de la plupart des décès précoces des patients brûlés. Le but de cette recherche est d’étudier la fréquence, le diagnostic précoce, les complications et la gestion des lésions par inhalation et de discuter la relation entre ce type de lésion et la mortalité. L’étude a inclus 130 patients brûlés (61 hommes et 69 femmes) atteints de lésions par inhalation hospitalisés au Centre des Brulés et au Service Thoracique de l’Hôpital Universitaire Menoufiya, Egypt, de janvier 2008 à janvier 2010. Les Auteurs ont constaté que la présence de lésions par inhalation, l’extension élevée de la surface brulée et l’âge avancé constituent des facteurs qui sont tous associés à une mortalité augmentée (p < 0,01). La fréquence globale des lésions par inhalation était de 46,3% (les 130 patients provenaient d’un nombre total de 281 victimes de brûlures). Le taux global de mortalité chez les patients atteints de lésions par inhalation était de 41,5% (54/130) contre 7,2% (11/151) chez les patients sans lésions par inhalation. Ces statistiques indiquent clairement que les lésions par inhalation ont constitué un facteur important pour prédire la mortalité chez les patients brûlés. Environ 80% des décès liés au feu sont dus non pas à la simple brûlure des voies aériennes mais à l’inhalation des produits toxiques, et en particulier des gaz du monoxyde de carbone et d’acide cyanhydrique. Les lésions par inhalation, provoquées dans la majorité des cas par les brûlures thermiques et normalement limitées aux voies respiratoires supérieures, peuvent avoir des complications majeures aux voies aériennes, comme aussi après les complications pulmonaires et systémiques, et elles provoquent un incrément de la mortalité des patients brûlés.

Keywords: INHALATION INJURY; MORTALITY.

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Figures

Fig. 1
Fig. 1. Burned male patient with inhalation injury at moment of admission. Family used oil to deal with burn.
Fig. 2
Fig. 2. Child with suspected inhalation injury with eyes closed because of severe face and lip oedema.
Fig. 3
Fig. 3. Deep burn in face. History of entrapment in closed space, soot around mouth. Patient drowsy, face and lip oedema.
Fig. 4
Fig. 4. Very deep burn in face, soot around mouth.
Table I
Table I. Mortality rate of patients with and without inhalation injury
Table II
Table II. Mortality of patients with inhalation injury in relation to age
Table III
Table III. Blood gases of burn patients with inhalation injury in relation to burns percentage
See this image and copyright information in PMC

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