Diagnosis and management of inhalation injury: an updated review.
In this article we review recent advances made in the pathophysiology, diagnosis, and treatment of inhalation injury. Historically, the diagnosis of inhalation injury has relied on nonspecific clinical exam findings and bronchoscopic evidence. The development of a grading system and the use of modalities such as chest computed tomography may allow for a more nuanced evaluation of inhalation injury and enhanced ability to prognosticate. Supportive respiratory care remains essential in managing inhalation injury. Adjuncts still lacking definitive evidence of efficacy include bronchodilators, mucolytic agents, inhaled anticoagulants, nonconventional ventilator modes, prone positioning, and extracorporeal membrane oxygenation. Recent research focusing on molecular mechanisms involved in inhalation injury has increased the number of potential therapies.
Department of Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD, 20889, USA.
Patrick F
PF
Walker
Department of General Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Fort Sam Houston, TX, 78234, USA. michelle.f.buehner.mil@mail.mil.
Michelle F
MF
Buehner
Department of Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Fort Sam Houston, TX, 78234, USA.
Leslie A
LA
Wood
Department of Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Fort Sam Houston, TX, 78234, USA.
Nathan L
NL
Boyer
United States Army Institute of Surgical Research, Fort Sam Houston, TX, 78234, USA.
Ian R
IR
Driscoll
United States Army Institute of Surgical Research, Fort Sam Houston, TX, 78234, USA.
Jonathan B
JB
Lundy
United States Army Institute of Surgical Research, Fort Sam Houston, TX, 78234, USA.
Leopoldo C
LC
Cancio
United States Army Institute of Surgical Research, Fort Sam Houston, TX, 78234, USA.|Department of Surgery, Uniformed Services University of the Health Sciences, Building A, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA.
Kevin K
KK
Chung
D015998:Abbreviated Injury Scale; D001993:Bronchodilator Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D006801:Humans; D011014:Pneumonia / Q000209:etiology; D012121:Respiration, Artificial; D015208:Smoke Inhalation Injury / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy
D001993:Bronchodilator Agents