Otterness Karalynn, Ahn Christine
Clinical Assistant Professor of Emergency Medicine, Stony Brook School of Medicine, Stony Brook, NY.
Clinical Assistant Professor, Residency Assistant Program Director, Department of Emergency Medicine, Stony Brook School of Medicine, Stony Brook, NY.
Emerg Med Pract. 2018 Mar;20(3):1-24. Epub 2018 Mar 1.
Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests. Treatment includes airway and respiratory support, lung protective ventilation, 100% oxygen or hyperbaric oxygen therapy for carbon monoxide poisoning, and hydroxocobalamin for cyanide toxicity. Due to its progressive nature, many patients with smoke inhalation injury warrant close monitoring for development of airway compromise.
烟雾吸入性损伤预示着火灾暴露患者的发病率和死亡率会增加。上呼吸道热烧伤、下呼吸道刺激物引起的炎症以及一氧化碳和氰化物的全身效应都可能导致损伤。目前缺乏吸入性损伤的标准化诊断方案，治疗主要是支持性的。临床医生应高度怀疑合并创伤性损伤。诊断主要依靠临床判断，支气管镜检查和其他辅助检查可提供帮助。治疗包括气道和呼吸支持、肺保护性通气、一氧化碳中毒时给予100%氧气或高压氧治疗以及氰化物中毒时给予羟钴胺素。由于其具有进展性，许多烟雾吸入性损伤患者需要密切监测气道是否出现受压情况。
