Diagnosis and Management of Inhalation Injuries in U. S. Children

Abstract

Inhalation injuries are the leading cause of mortality in fire related deaths in children, who because of their small and fragile airways have a greater risk of mortality than their adult counterparts. Direct injury to the lung parenchyma can be caused by a combination of heat and chemical damage, and their secondary effects. Diagnosis. Fiberoptic bronchoscopy is the current diagnostic standard when determining the presence and severity of an inhalation injury Chest CT (computed tomography) has been described as an adjunct to identifying parenchymal lung damage in inhalation injury patients. Management. The benefits of high tidal volume ventilation in this patient population include decreased ventilation days, decreased ARDS, and decreased atelectasis [The goals of medical therapy in patients with an inhalation injury are: 1) decrease bronchospasm, and 2) decrease airway edema. Bronchodilators are the mainstay of medical therapy for inhalation injuries. Chest physiotherapy including suctioning, coughing techniques, and early mobilization can be beneficial for patients with inhalation injuries. Summary. Most children who sustain a major burn injury survive. Although those who sustain an inhalation injury are at greater risk for morbidity and mortality, modern modes of airway management and ventilatory support generally result in good outcomes.

Keywords

Inhalation injury / burn / children / pediatric / intubation / respiratory support

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Shahi N., Phillips R., Moulton S.L.