MANAGEMENT OF ACUTE RESPIRATORY TRACT BURNS, CLINICAL AND EXPERIMENTAL STUDY

Abstract

This prospective study included 180 burned patients whom were admitted to Burn Unit, Tanta University Hospital in the period between 1 /1 /1999 and Ill /200 I and were presented with clinical manifestations

suggesting inhalation injury.

For each patient, a detailed history clinical evaluation including personal data, time of the burn accident, history of closed space entrapment and its duration, causative agent, manner of burn, nature of burned materials at the scene of the accident, history of disturbed consciousness and associated systemic diseases. We evaluated the coetaneous burns regarding the extent, location and depth with looking for indicators for inhalation injury, which are: deep facial and neck burns, singed nasal hairs, mucosal burns of lips and oral cavity,• burned pharyrgeal mucosa, soot in the nostrils and throat, sputum streaked with carbonaceous materials, tachy prea, dyspnea or stridor, hoarseness of voice, cough and rhonchi and altered conscious level and scorit:g was done using C.S.S. (mild, med. severe). Also, associated burn shock or can comitant injuries were evaluated and treated properly. '

Resuscitation of the patients was sta1ied immediately specially towards maintaining patient airway by tracheostomy or endotracheal intubation if the patient was presented with or developed offer airway obstruction. Also, humidified oxygen therapy after taking arterial blood sample for ABG estimation was done routinely, fluid resuscitation using lactated ringer's solution following parkland formula with correction of any acid bone disturbances and control of pain by pethidine or nonsteroidal antiinflamatory drugs was started soon. All patients followed the regiemen of selective gastrointestinal decontamination program with avoidance of corticosteroid therapy and antibiotherapy unless they developed manifestations of sepsis or positive blood or wound cultures were evident. Systemic and local antiinflamatory and soothing medications to the respiratory tract were used.