Department of Pediatric Surgery, Ankara City Hospital, Ankara-Turkey.
Department of Pediatric Surgery, Yıldırım Beyazıt University Faculty of Medicine, Ankara-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 May;28(5):585-592. doi: 10.14744/tjtes.2021.84848.
We present our approach of pediatric burned patients with the suspicion of inhalation injury.
This retrospective study was conducted on children with the suspicion of inhalation injury admitted to our burn center from December 2009 to December 2019. We collected data on patient demographics, total burn surface area (TBSA), presence of inhalation injury, level of carboxyhemoglobin, grade of inhalation injury, duration of mechanical ventilation, reintubation rate, total length of hospital stay, and the mortality rate. We also reviewed the required treatment of patients with inhalation injury.
A total of sixty pediatric burn patients were suspected inhalation injury were included in this retrospective study. 40 pa-tients included in the study were male. Age average of the patients was 87.7 months. Total burned surface area average was 32%. 46 of these patients had inhalation injury. Patients with larger cutaneous burn and needed early intubation have a higher risk of inhalation injury. There was no significant relation between inhalation injury grades and mortality and treatment protocols. Higher levels of car-boxyhemoglobin and larger TBSA are the risk factors for mortality at univariate analysis. Pediatric patient with inhalation injury whose TBSA is higher than 47.5% has a 5 times higher risk of mortality at multivariate analysis.
This study demonstrated that TBSA is the risk factor that independently affects the mortality in pediatric patients with inhalation injury. Among the patients with higher than 47.5% burn surface area, the mortality rate rises 5 times.
我们提出了一种针对疑似吸入性损伤的儿科烧伤患者的处理方法。
本回顾性研究纳入了 2009 年 12 月至 2019 年 12 月期间因疑似吸入性损伤而收入我院烧伤中心的儿童患者。我们收集了患者人口统计学、总烧伤面积（TBSA）、吸入性损伤的存在、碳氧血红蛋白水平、吸入性损伤程度、机械通气时间、再插管率、总住院时间和死亡率的数据。我们还回顾了吸入性损伤患者的所需治疗。
本回顾性研究共纳入了 60 例疑似吸入性损伤的儿科烧伤患者。其中 40 例为男性，患者平均年龄为 87.7 个月，平均 TBSA 为 32%。46 例患者存在吸入性损伤。有较大皮肤烧伤且需要早期插管的患者，发生吸入性损伤的风险更高。吸入性损伤程度与死亡率和治疗方案之间无显著关系。单因素分析显示，较高的碳氧血红蛋白水平和较大的 TBSA 是死亡的危险因素。多因素分析显示，TBSA 高于 47.5%的吸入性损伤儿科患者的死亡率增加 5 倍。
本研究表明，TBSA 是影响吸入性损伤儿科患者死亡率的独立危险因素。在烧伤面积超过 47.5%的患者中，死亡率增加 5 倍。
