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[吸入性损伤——流行病学、诊断与治疗]

[Inhalation injury--epidemiology, diagnosis and therapy].

作者信息

Thaler Ulrich, Kraincuk Paul, Kamolz Lars-Peter, Frey Manfred, Metnitz Philipp G H

机构信息

Universitätsklinik für Anästhesie, Allgemeine Intensivmedizin und Schmerztherapie, Medizinische Universität Wien, Wien, Austria.

出版信息

Wien Klin Wochenschr. 2010 Jan;122(1-2):11-21. doi: 10.1007/s00508-010-1303-7.

Abstract

OBJECTIVE

Inhalation injury is a vitally threatening medical syndrome, which might appear in patients with or without burn injuries. Thus, knowledge about development, diagnosis and treatment of inhalation injury should be available for each physician working in an intensive care unit.

METHODS

This review starts with the causal and formal pathogenesis of inhalation injuries. Furthermore, diagnosis and treatment in the critical care setting are presented, followed by the discussion of possible complications. Specific intoxications such as carbon monoxide are due to their importance separately discussed.

CONCLUSIONS

Inhalation injury present with an attributable excess mortality and thus worsen the prognosis of burned patients. New insights into the pathogenesis of inhalation injury, however, have led to improved therapeutic possibilities with improved outcome. Necessary prerequisites are a timely diagnosis and restrictive volume management, especially in patients with extensive burns. Prospective studies are needed to be able to answer the many emerging questions.

摘要

目的

吸入性损伤是一种危及生命的医学综合征,可出现在有或无烧伤的患者中。因此,每个在重症监护病房工作的医生都应了解吸入性损伤的发生、诊断和治疗。

方法

本综述首先介绍吸入性损伤的病因和形式发病机制。此外,还介绍了重症监护环境中的诊断和治疗,随后讨论了可能的并发症。诸如一氧化碳等特定中毒因其重要性而单独讨论。

结论

吸入性损伤导致额外的可归因死亡率,从而恶化烧伤患者的预后。然而,对吸入性损伤发病机制的新见解带来了改善的治疗可能性和更好的结果。必要的前提条件是及时诊断和限制性容量管理,尤其是在大面积烧伤患者中。需要进行前瞻性研究以回答许多新出现的问题。

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