Chest
Clinical Investigations in Critical CareEarly Complications and Value of Initial Clinical and Paraclinical Observations in Victims of Smoke Inhalation Without Burns
Section snippets
MATERIALS AND METHODS
This retrospective study was conducted on patients who were admitted to the ICU (Réanimation Toxicologique, Hopital Fernand Widal) from January 1987 to December 1992. Patients included in this study were victims of smoke inhalation following household fires who were taken in charge by the emergency medical squad of the Paris Fire Brigade. Patients with cutaneous burns or multiple trauma or those affected by a blast were excluded. A cardiac arrest at the scene was also a cause of exclusion.
RESULTS
Sixty-four consecutive patients were included in this study. The population included 36 men and 28 women; their mean age was 47.3 years (range, 20 to 94 years). For the 64 victims, the mean ICU stay was 5.8 days (range, 1 to 33 days). Thirty-five of the 64 victims required mechanical ventilation for a mean duration of 101.2 h (range, 8 to 648 hours). Two patients died, respectively, on day 6 and 7, from progressive respiratory failure.
During the same period, 10 patients were found in cardiac
DISCUSSION
Numerous pulmonary complications have been reported following smoke inhalation, but most studies concerned victims with burns. Inhalation injury is present in approximately one third of the burned patients and increases mortality in relation to age and extent of burn.4,5 In a review of 239 patients hospitalized in a burn unit, Teixidor et al5 found that more than 30% of the patients developed pulmonary complications and, of these, 75% died. Tracheobronchitis, pneumonia, pulmonary congestion,
ACKNOWLEDGMENT
We thank S. Borron for his help in preparing this article.
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Reprint requests: Dr. Hantson, Department of Intensive Care, Cliniques Universitaires St-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium. E-mail: [email protected]