[The diagnostic significance of disordered gas exchange in inhalation trauma]

52 patients with burn injuries were prospectively investigated. In all cases intubation was necessary because of clinical signs of smoke inhalation. We studied whether a correlation could be established between the clinical signs and bronchoscopic findings and the degree of gas exchange disorder. The disturbed oxygenation was defined by the average alveolo-arterial oxygen quotient of the first 24 hours. The inhalation injury was classified by clinical signs and bronchoscopic findings (inhalation injury score). The average alveolo-arterial O2-quotient of the first 24 hours and the inhalation injury score showed a high correlation coefficient (r = 0.77). No correlation was seen between the severity of gas exchange disorder and the amount of burned body surface area (r = 0.20) respectively the age of the patients (r = 0.27). According to these results early onset of disorders in gas exchange after burn injury reflects smoke inhalation. Therefore the gas analysis from arterial blood can be a very helpful diagnostic method and allows to estimate the degree of pulmonary damage by inhalation injury.