Galeiras Rita
Complexo Hospitalario Universitario, A Coruna, Spain; Burn Unit, Instituto de Investigacion Biomedica de A Coruna, A Coruna, Spain.
Mediastinum. 2021 Jun 25;5:16. doi: 10.21037/med-21-7. eCollection 2021.
Burn Units frequently provide care to patients who have burn injuries and concomitant smoke inhalation injury. Inhalation damage is a complex multifaceted lung and systemic disease process, and the leading cause of mortality and morbidity in victims of fire tragedies. The degree of airway injury depends on the composition of smoke and the duration of smoke exposure. The prevalence of inhalation damage and related mortality rates among fire victims is high all over the world. This article presents the potential clinical impacts of this syndrome and the most important factors to consider when examining patients that have survived the scene of an accident who require hospital admission. Anatomically, injuries are divided into three classes: (I) heat injury which is restricted to upper airway; (II) local chemical irritation throughout the respiratory tract and (III) systemic toxicity as may occur with inhalation of carbon monoxide or cyanide. Treatment options between these three subtypes differ based on the pathophysiologic changes that each one elicits. Supportive respiratory care remains essential in managing inhalation injury. In addition, we have also reviewed current treatment strategies and future lines of research in this field. These advances provide hope for reversal of specific mechanisms of morbidity and improvement in outcomes.
烧伤科经常为烧伤合并烟雾吸入性损伤的患者提供治疗。吸入性损伤是一个复杂的多方面的肺部和全身性疾病过程，是火灾悲剧受害者死亡和发病的主要原因。气道损伤的程度取决于烟雾的成分和烟雾暴露的持续时间。全世界火灾受害者中吸入性损伤的发生率和相关死亡率都很高。本文介绍了该综合征的潜在临床影响，以及在检查从事故现场幸存下来需要住院治疗的患者时需要考虑的最重要因素。从解剖学角度来看，损伤分为三类：（I）仅限于上呼吸道的热损伤；（II）整个呼吸道的局部化学刺激；（III）吸入一氧化碳或氰化物可能发生的全身毒性。这三种亚型之间的治疗选择因各自引发的病理生理变化而异。支持性呼吸护理在管理吸入性损伤方面仍然至关重要。此外，我们还回顾了该领域当前的治疗策略和未来的研究方向。这些进展为逆转特定的发病机制和改善治疗结果带来了希望。
