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Published on: August 23, 2022
Quantifying the impact of inhalational burns: a prospective study
Si Jack Chong1, Yee Onn Kok1, Rosanna Xiang Ying Tay1
11Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Level 5, Academia, Singapore, 169865 Singapore.
Inhalational burn injuries significantly increase patient mortality, length of hospital stay, and the risk of complications such as acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS). Early identification and management are crucial for improving outcomes in burn patients with inhalational injury.
Area of Science:
- Trauma Surgery
- Critical Care Medicine
- Burn Management
Background:
- Inhalational injury is a significant contributor to morbidity and mortality in burn patients.
- Understanding its impact on clinical outcomes, complications, and bacteriology is essential for effective patient care.
Purpose of the Study:
- To analyze the clinical outcomes, complications, and bacteriology associated with inhalational burn injuries.
- To compare these factors in patients with and without inhalational injury.
Main Methods:
- A prospective study conducted at a single burn center over 15 months.
- Inclusion criteria based on history, symptoms, and nasoendoscopy for inhalational injury diagnosis.
- Standardized criteria (Berlin, AKIN, ABA) used for diagnosing ARDS, AKI, and infections.
Main Results:
- Patients with inhalational burns experienced longer hospital stays, more surgeries, and higher mortality rates compared to those with cutaneous injury alone.
- Higher incidence of ARDS (48.6%), AKI (37.1%), bacteraemia (31.4%), pneumonia (37.1%), and burn wound infection (51.4%) in the inhalational injury group.
- *Acinetobacter baumannii* was the most common pathogen; Gram-negative bacteria predominated in tissue cultures from patients with inhalational injury.
Conclusions:
- Inhalational injury accompanying burns substantially elevates the risk of prolonged hospitalization, mortality, and severe complications.
- Complications include acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), and various infections, including sepsis.
- The findings underscore the critical impact of inhalational injury on burn patient prognosis and necessitate focused management strategies.
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