Monteiro D, Silva I, Egipto P, Magalhães A, Filipe R, Silva A, Rodrigues A, Costa J
Department of Plastic, Reconstructive, Aesthetic Surgery and Burn Unit, Centro Hospitalar de São João, Porto, Portugal.
Burn Unit, Centro Hospitalar de São João, Porto, Portugal.
Ann Burns Fire Disasters. 2017 Jun 30;30(2):121-125.
Inhalation injury (InI) is known to seriously affect the prognosis of burn patients, as it is strongly associated with high morbidity and mortality. Despite major advances in the treatment of burn patients in the past years, advances in the treatment of smoke InI have been somewhat limited; mortality reduction mostly results from improvements in critical care. It is difficult to separate the contribution of InI from other mechanisms that also affect respiratory tract and lungs. The aim of this study was to compare patients with and without InI and to identify prognostic factors among patients with smoke InI. Patients with InI displayed higher total body surface area (TBSA) burned, higher incidence of pneumonia and acute respiratory distress syndrome (ARDS), a higher rate of positive blood cultures and a significantly higher death rate. We could conclude that older age, higher TBSA, ARDS and pneumonia were independent predictive factors for mortality in our global study population. Older age and higher TBSA were the only independent factors found to be predictive of mortality in patients with InI.
吸入性损伤（InI）已知会严重影响烧伤患者的预后，因为它与高发病率和死亡率密切相关。尽管在过去几年中烧伤患者的治疗取得了重大进展，但烟雾吸入性损伤的治疗进展却较为有限；死亡率的降低主要源于重症监护的改善。很难将吸入性损伤的影响与其他也会影响呼吸道和肺部的机制区分开来。本研究的目的是比较有和没有吸入性损伤的患者，并确定烟雾吸入性损伤患者的预后因素。有吸入性损伤的患者烧伤的总体表面积（TBSA）更高，肺炎和急性呼吸窘迫综合征（ARDS）的发生率更高，血培养阳性率更高，死亡率也显著更高。我们可以得出结论，在我们的全球研究人群中，年龄较大、TBSA较高、ARDS和肺炎是死亡率的独立预测因素。年龄较大和TBSA较高是在有吸入性损伤的患者中发现的仅有的预测死亡率的独立因素。
