Recent Updates in Management of Smoke Inhalation Injury in Burn Victims

Abstract

Inhalation injury can result from direct local thermal & chemical exposures, immune responses to these factors, systemic effects of inhaled toxins, accrual of endobronchial debris, and secondary infection. Structural fires generate smoke that contains a large variety of chemicals, products of incomplete combustion, and aerosolized debris of widely varying particle sizes. The location and severity of injury depends on several factors, including the ignition source, the size and diameter of the particles in the smoke, the duration of exposure, and the solubility of gases. Direct toxin damage is caused by the low molecular weight constituents of smoke because of their pH, ability to form free radicals, and ability to reach the distal airways and alveoli. Based on the localization of insult, inhalation injury is classified into injuries of the upper airway, the tracheobronchial system, or the lung parenchyma. It is important that SII be diagnosed early, thus facilitating an appropriate treatment strategy. Accurately diagnosing the se