Bargues L, Vaylet F, Le Bever H, L'Her P, Carsin H
Centre de Traitement des Brûlés, Hôpital d'Instruction des Armées Percy, Clamart, France.
Rev Mal Respir. 2005 Jun;22(3):449-60. doi: 10.1016/s0761-8425(05)85572-x.
Smoke inhalation and respiratory complications are still the major causes of mortality in severely burned patients.
The diagnosis is suspected clinically on the basis of history and physical examination and can be confirmed bronchoscopically. Respiratory failure in burned patients occurs through a number of associated mechanisms. Pneumonitis and adult respiratory distress syndrome (ARDS) are common early complications. New pulmonary treatments and advances in ventilation have reduced the incidence of both barotrauma and infectious complications. Tracheal stenosis can occur as a late complication of prolonged mechanical ventilation.
Clinical and experimental studies have shown that damage to the mucosal barrier and the release of inflammatory mediators are the most important pathophysiological events following smoke inhalation. Manipulation of the inflammatory response following inhalation may be a treatment option in the distant future.
Inhalation injury occurring in burned patients can produce severe respiratory and systemic complications.
烟雾吸入和呼吸并发症仍是重度烧伤患者死亡的主要原因。
临床上根据病史和体格检查怀疑诊断，并可通过支气管镜检查确诊。烧伤患者的呼吸衰竭通过多种相关机制发生。肺炎和成人呼吸窘迫综合征（ARDS）是常见的早期并发症。新的肺部治疗方法和通气技术的进步降低了气压伤和感染性并发症的发生率。气管狭窄可能作为长期机械通气的晚期并发症出现。
临床和实验研究表明，烟雾吸入后黏膜屏障受损和炎症介质释放是最重要的病理生理事件。在遥远的未来，控制吸入后的炎症反应可能是一种治疗选择。
烧伤患者发生的吸入性损伤可导致严重的呼吸和全身并发症。
