Rehberg Sebastian, Maybauer Marc O, Enkhbaatar Perenlei, Maybauer Dirk M, Yamamoto Yusuke, Traber Daniel L
Department of Anesthesiology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA, Tel.: +1 409 772 6405, ,
Expert Rev Respir Med. 2009 Jun 1;3(3):283-297. doi: 10.1586/ERS.09.21.
Smoke inhalation injury continues to increase morbidity and mortality in burn patients in both the third world and industrialized countries. The lack of uniform criteria for the diagnosis and definition of smoke inhalation injury contributes to the fact that, despite extensive research, mortality rates have changed little in recent decades. The formation of reactive oxygen and nitrogen species, as well as the procoagulant and antifibrinolytic imbalance of alveolar homeostasis, all play a central role in the pathogenesis of smoke inhalation injury. Further hallmarks include massive airway obstruction owing to cast formation, bronchospasm, the increase in bronchial circulation and transvascular fluid flux. Therefore, anticoagulants, antioxidants and bronchodilators, especially when administered as an aerosol, represent the most promising treatment strategies. The purpose of this review article is to provide an overview of the pathophysiological changes, management and treatment options of smoke inhalation injury based on the current literature.
在第三世界国家和工业化国家，吸入性损伤持续增加烧伤患者的发病率和死亡率。缺乏关于吸入性损伤诊断和定义的统一标准，导致尽管进行了广泛研究，但近几十年来死亡率变化不大。活性氧和氮物种的形成，以及肺泡内环境稳态的促凝和抗纤溶失衡，在吸入性损伤的发病机制中都起着核心作用。其他特征还包括由于铸型形成、支气管痉挛、支气管循环增加和跨血管液体通量导致的大规模气道阻塞。因此，抗凝剂、抗氧化剂和支气管扩张剂，尤其是以气雾剂形式给药时，是最有前景的治疗策略。这篇综述文章的目的是根据当前文献概述吸入性损伤的病理生理变化、管理和治疗选择。
