ARDS among cutaneous burn patients combined with inhalation injury: early onset and bad outcome

Our aims are to determine the clinical and preclinical characteristics and outcome of ARDS among burn patients with inhalation injury. A retrospective study was conducted on 66 selected patients with ARDS, treated in the ICU of the National Burns Hospital from 11/2013 to 10/2016. The patients were divided into two groups and matched by age and burn extent: the study group consisted of 33 patients with inhalation injury and the control group 33 patients without inhalation injury. Outcome measures included blood gas criteria and oxygenation state at ARDS onset, mechanical ventilation duration, length of stay in the ICU and in the hospital, ventilation-free time and mortality rate until 28 days postburn. Results showed that ARDS onset was earlier in the study group (5.9 ±.7 vs. 9.2 ± .9 days postburn respectively; p < 0.01) and blood oxygenation disorder was more severe (PaO2/FiO2: 117.8 ± 6.1 vs. 125.9 ± 6.5 respectively; p < .01). There was no significant difference between the two groups (p > .05) regarding incidence of complications, ventilation time, ventilation-free duration, and length of stay in the ICU and in the hospital. Mortality rate until 28 days post burn was significantly higher among the study group (69.7% vs. 54.6% respectively; p < .001). In addition, time from admission and from ARDS onset to death was shorter in the study group (P < .05). In conclusion, compared to cutaneous burn-induced ARDS, ARDS in patients with inhalation injury has earlier onset, causes more severe oxygenation disorder and has a higher mortality rate.