Pulmonary complications in burn patients

In recent years, pulmonary complications have become a major cause of death in burn victims. Familiarity with the spectrum of these complications leads to an earlier and more specific diagnosis based on chest radiographs. We reviewed the medical records and chest radiographs of 239 patients admitted to our burn unit over a one-year period. Pulmonary complications were categorized on the basis of their anatomic location in the respiratory tract and on whether they were the result of direct chemical injury from smoke inhalation, or were secondary to inhalation injury with or without cutaneous burns. Tracheobronchitis, chemical pulmonary edema, and adult respiratory distress syndrome (ARDS) resulted from direct injury. Pneumonia, ARDS, pulmonary congestion, atelectasis and pulmonary emboli were the main complications secondary to the injury. Pulmonary complications developed in 76 patients (31.8%) and, of these, 57 died (75%). Patients involved in a closed space fire and those who had a burn involving 50% or more of their surface area seem to be at the greatest risk of developing pulmonary complications.