[Stepwise treatment in patients with isolated thermal inhalation injury]

To evaluate the efficiency of stepwise treatment in patients with isolated thermal inhalation injury (TIJ).

The study enrolled 101 patients with isolated TIJ. A study group (n=56) was treated at the Pulmonology Department after managing at the Burn Center (BC); a control group (n=45) received no systematic treatment after discharging from BC. The magnitude of respiratory symptoms (according to the rating system) and external respiratory function (ERF) was evaluated and fibrobronchoscopy was made in all the included patients at their discharge from BC. On admission to the Pulmonology Department, the study group patients underwent evaluation of the magnitude of respiratory symptoms, EFR, and lung diffusing capacity, determination of blood gas composition and exercise tolerance, and chest computed tomography. Respiratory symptoms, ERF, and exercise tolerance were evaluated in all the included patients one month after hospital discharge.

Examination at the Pulmonology Department established preserved respiratory manifestations in patients who had to continue therapy. The use of beta2-agonists or inhaled steroids used in combination or alone need, mucoregulators or antibiotics revealed the efficiency of a stepwise approach to managing patients with TIJ.

There is evidence that it is expedient to perform two-stage treatment in patients with TIJ, by transferring them from BC to a specialized pulmonology hospital, which substantially enhances the efficiency of medical care for this contingent of patients.