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Inhalation burns in children

L Whitelock-Jones1, D H Bass, A J Millar

  • 1Department of Paediatric Surgery, Red Cross Children's Hospital, University of Cape Town, Klipfontein Road, Rondebosch, 7700, South Africa.

Pediatric Surgery International
|January 23, 1999
PubMed
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Inhalation injury in children is often unrecognized and can lead to severe respiratory distress and death. Early diagnosis and management of inhalation burns are crucial for improving survival rates in pediatric burn patients.

Area of Science:

  • Pediatric Burn Care
  • Respiratory Medicine
  • Trauma Surgery

Background:

  • Childhood burn survival has improved, but mortality is often linked to total body surface area burned and unrecognized inhalation injury.
  • Inhalation injury significantly contributes to morbidity and mortality in pediatric thermal injuries.
  • Understanding the incidence and impact of inhalation injury is vital for improving outcomes.

Purpose of the Study:

  • To determine the incidence, clinical presentation, and pathology of inhalation injury in children.
  • To assess the contribution of inhalation injury to morbidity and mortality in pediatric burn patients.
  • To evaluate the effectiveness of diagnostic and management strategies for inhalation injury.

Main Methods:

  • Retrospective review of 4,451 pediatric thermal injury cases over 10 years.

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  • Diagnosis of inhalation burns confirmed clinically, endoscopically, and post-mortem.
  • Classification of inhalation injury using the Moylan scale (upper-airway, major-airway, parenchymal).

    • Main Results:

    • Inhalation burns occurred in 2.2% of children (97 cases), predominantly in fire burn victims.
    • Key symptoms included stridor and progressive respiratory distress, sometimes with delayed onset up to 72 hours.
    • Major complications included secondary pneumonia (41.5% fire, 55% hot-water burns) and persistent airway damage, contributing to significant mortality.

    Conclusions:

    • Inhalation burns in children are frequently underdiagnosed and can present with delayed symptoms.
    • Early clinical diagnosis, supported by endoscopy, is essential for effective airway management.
    • Prompt and appropriate management of inhalation injury is critical to reduce pediatric burn morbidity and mortality.