Department of Surgical Intensive Care, Singapore General Hospital, Singapore.
Department of Anaesthesiology, Singapore General Hospital, Singapore.
Singapore Med J. 2020 Jan;61(1):46-53. doi: 10.11622/smedj.2019048. Epub 2019 Jun 14.
Inhalation injury is a serious consequence of a fire or an explosion, with potential airway compromise and respiratory complications. We present a case series of five patients with inhalational burns who presented to Singapore General Hospital and discuss our approach to their early management, including early evaluation and planning for the upper and lower airway, coexisting cutaneous burns, and monitoring their ICU (intensive care unit) severity of illness, sepsis and acute respiratory distress syndrome. All five patients suffered various grades of inhalation injury. The patients were initially assessed by nasolaryngoscopy, and three patients were prophylactically intubated before being sent to the emergency operating theatre for definitive airway and burns management with fibreoptic bronchoscopy. All patients were successfully extubated and discharged stable. Various complications can arise as a result of an inhalation injury. Based on our cases and literature review, we propose a standardised workflow for patients with inhalation injury.
吸入性损伤是火灾或爆炸的严重后果,可能导致气道受损和呼吸并发症。我们报告了五例吸入性烧伤患者的病例系列,并讨论了我们对其早期管理的方法,包括对上、下呼吸道的早期评估和规划、并存的皮肤烧伤以及监测其 ICU(重症监护病房)疾病严重程度、脓毒症和急性呼吸窘迫综合征。这五名患者均患有不同程度的吸入性烧伤。患者最初通过鼻喉镜进行评估,其中 3 名患者在被送往急诊手术室进行明确的气道和烧伤管理之前,预防性地进行了气管插管,同时进行纤维支气管镜检查。所有患者均成功拔管并稳定出院。吸入性损伤可能会引起各种并发症。基于我们的病例和文献复习,我们提出了一个吸入性损伤患者的标准化工作流程。