Citation

Rech TH, Boniatti MM, Franke CA, Lisboa T, Wawrzeniak IC, Teixeira C, Maccari JG, Schaich F, Sauthier A, Schifelbain LM, Riveiro DF, da Fonseca DL, Berto PP, Marques L, dos Santos MC, de Oliveira VM, Dornelles CF, Vieira SR. Burns 2016; 42(4): 884-890.

Affiliation

Department of Intensive Care Medicine, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Porto Alegre, Brazil.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.burns.2016.02.017

PMID

26975698

Abstract

OBJECTIVE: To describe the pre-hospital, emergency department, and intensive care unit (ICU) care and prognosis of patients with inhalation injury after exposure to indoor fire and smoke.

MATERIALS AND METHODS: This is a prospective observational cohort study that includes patients admitted to seven ICUs after a fire disaster. The following data were collected: demographic characteristics; use of fiberoptic bronchoscopy; degree of inhalation injury; percentage of burned body surface area; mechanical ventilation parameters; and subsequent events during ICU stay. Patients were followed to determine the ICU and hospital mortality rates.

RESULTS: Within 24h of the incident, 68 patients were admitted to seven ICUs. The patients were young and had no comorbidities. Most patients (n=35; 51.5%) only had an inhalation injury. The mean ventilator-free days for patients with an inhalation injury degree of 0 or I was 12.5±8.1 days. For patients with an inhalation injury degree of II or III, the mean ventilator-free days was 9.4±5.8 days (p=0.12). In terms of the length of ICU stay for patients with degrees 0 or I, and patients with degrees II or III, the median was 7.0 days (5.0-8.0 days) and 12.0 days (8.0-23.0 days) (p<0.001), respectively. In addition, patients with a larger percentage of burned surface areas also had a longer ICU stay; however, no association with ventilator-free days was found. The patients with <10% of burned body surface area showed a mean of 9.2±5.4 ventilator-free days. The mean ventilator-free days for patients who had >10% burned body surface area was 11.9±9.5 (p=0.26). The length of ICU stay for the <10% and >10% burned body surface area patients was 7.0 days (5.0-10.0 days) and 23.0 days (11.5-25.5 days) (p<0.001), respectively.

CONCLUSIONS: We conclude that burn patients with inhalation injuries have different courses of disease, which are mainly determined by the percentage of burned body surface area.

Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Language: en