Schramm V L, Mattox D E, Stool S E
Laryngoscope. 1981 Sep;91(9 Pt 1):1417-26.
The laser-ignited airway explosion is a shocking emergency. Techniques available for prevention of an airway fire minimize the risk, but they are not applicable in all circumstances. The severity of the patient's injury depends on the duration and intensity of the burn. Prompt, appropriate management is facilitated if the operating team has previously discussed and "rehearsed" this potential disaster. The distal airway burn produced by an ignited endotracheal tube differs from an inhalation burn in character and severity. The anatomic and respiratory effects occurring subsequent to the laser-induced burn are examined. Emergency care requires immediate elimination of the fire, removal of the tube and any foreign body or debris, and usually a tracheostomy. A program of medical and endoscopic management is suggested.
激光引发的气道爆炸是一种令人震惊的急症。现有的预防气道火灾的技术可将风险降至最低，但并非在所有情况下都适用。患者损伤的严重程度取决于烧伤的持续时间和强度。如果手术团队之前已经讨论并“演练”过这种潜在的灾难，就能更迅速、恰当地进行处理。气管内导管点燃所产生的远端气道烧伤在特征和严重程度上与吸入性烧伤不同。本文研究了激光所致烧伤后发生的解剖学和呼吸效应。急救需要立即灭火，取出导管以及任何异物或碎片，通常还需要进行气管造口术。本文还提出了一套医学和内镜处理方案。
