title: Clinico-pathological profile and outcome of inhalational burns.
abstract: OBJECTIVE
  To determine clinico-pathological profile and outcome of inhalational burns in a specialized burns treatment unit.
  
  
  METHODS
  Case-series.
  
  
  METHODS
  The Department of Plastic Surgery and Burns Centre Unit, Combined Military Hospital, Kharian Cantonment in March 2005.
  
  
  METHODS
  Patients of inhalational burns were included and evacuated within 30 hours of accident to the specialized burns centre after immediate resuscitation. Total Body Surface Area (TBSA) involved in burns was calculated. Complete blood count and renal profile along with serum albumin and total proteins was obtained. Portable chest radiographs and bronchoscopic examination was conducted. Escarotomies were carried and wounds were covered with split thickness skin grafts. Ventilatory support was used as needed. Comparison of the clinico-pathological profile of surviving and fatal cases was done for significance using t-test.
  
  
  RESULTS
  There were 19 patients of inhalational burns, 8 (42%) of whom expired. The mean percentage of TBSA in 11 surviving patients was 50+/-10.87 and 70+/-15.46 in fatal cases. The mean haemoglobin (Hb) on admission was 15.8+/-1.6 g/dL and after fluid resuscitation it became 11.4+/-1.5 g/dL. The mean Total Leucocyte Count (TLC) in surviving patients was 9.6+/-6.1 x 10(9)/L and 1.5+/-2.3 x 10(9)/L in fatal cases (p=0.001). The mean platelet count of surviving patients was 205+/-63 x 10(12)/L while in fatal cases was 58+/-48 x 10(12)/L (p=0.05). The serum urea levels in surviving patients was 4.3+/-2 mmol/L while in fatal cases was 8.6+/-0.9 mmol/L (p=0.05). The serum creatinine levels were 98.2+/-16.5 micromol/L in the survivor group and 249.5+/-76 micromol/L in the mortality group (p=0.05). The serum total protein in surviving patients was 63+/-8 g/dL while in mortality cases it was 57+/-7 g/L. Serum albumin in the survivor group was 36.7+/-5 g/L and 35+/-4 g/L in fatal cases. Significant in Hb, protein and albumin levels. All the expired patients had acute respiratory distress syndrome while acute renal failure with multi-organ failure co-existed in 6 patients.
  
  
  CONCLUSIONS
  Inhalational burns injury cases multi-system injury with high mortality. Body area involvement, total leucocyte count, platelet count, serum area and serum creatinine are important indicators of survival.
authors.affiliation: Department of General Surgery, Combined Military Hospital, Bahawal Nagar Cantonment. badar_murtaza@yahoo.com
authors.forename: Badar
authors.initials: B
authors.lastname: Murtaza
authors.forename: Muhammad Ashraf
authors.initials: MA
authors.lastname: Sharif
authors.forename: Muhammad Sarmad
authors.initials: MS
authors.lastname: Tamimy
authors.forename: Muhammad Farooq
authors.initials: MF
authors.lastname: Dar
authors.forename: Aneel
authors.initials: A
authors.lastname: Aslam
authors.forename: Syed Tahawar
authors.initials: ST
authors.lastname: Mujtaba Kazmi
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ishaque
mesh_terms: D000328:Adult; D001798:Blood Proteins / Q000032:analysis; D001830:Body Surface Area; D002059:Burns, Inhalation / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D003404:Creatinine / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D010976:Platelet Count; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome; D014508:Urea / Q000097:blood
chemical_list: D001798:Blood Proteins; D006454:Hemoglobins; D012709:Serum Albumin; D014508:Urea; D003404:Creatinine