1. Inhalation injury after exposure to indoor fire and smoke: The Brazilian disaster experience.
- Author
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Rech TH, Boniatti MM, Franke CA, Lisboa T, Wawrzeniak IC, Teixeira C, Maccari JG, Schaich F, Sauthier A, Schifelbain LM, Riveiro DF, da Fonseca DL, Berto PP, Marques L, Dos Santos MC, de Oliveira VM, Dornelles CF, and Vieira SR
- Subjects
- Adult, Aged, Brazil, Bronchoscopy statistics & numerical data, Burns pathology, Disasters, Female, Hospital Mortality, Humans, Intensive Care Units statistics & numerical data, Length of Stay statistics & numerical data, Male, Middle Aged, Prognosis, Prospective Studies, Respiration, Artificial statistics & numerical data, Severity of Illness Index, Burns complications, Smoke Inhalation Injury therapy
- Abstract
Objective: To describe the pre-hospital, emergency department, and intensive care unit (ICU) care and prognosis of patients with inhalation injury after exposure to indoor fire and smoke., Materials and Methods: This is a prospective observational cohort study that includes patients admitted to seven ICUs after a fire disaster. The following data were collected: demographic characteristics; use of fiberoptic bronchoscopy; degree of inhalation injury; percentage of burned body surface area; mechanical ventilation parameters; and subsequent events during ICU stay. Patients were followed to determine the ICU and hospital mortality rates., Results: Within 24h of the incident, 68 patients were admitted to seven ICUs. The patients were young and had no comorbidities. Most patients (n=35; 51.5%) only had an inhalation injury. The mean ventilator-free days for patients with an inhalation injury degree of 0 or I was 12.5±8.1 days. For patients with an inhalation injury degree of II or III, the mean ventilator-free days was 9.4±5.8 days (p=0.12). In terms of the length of ICU stay for patients with degrees 0 or I, and patients with degrees II or III, the median was 7.0 days (5.0-8.0 days) and 12.0 days (8.0-23.0 days) (p<0.001), respectively. In addition, patients with a larger percentage of burned surface areas also had a longer ICU stay; however, no association with ventilator-free days was found. The patients with <10% of burned body surface area showed a mean of 9.2±5.4 ventilator-free days. The mean ventilator-free days for patients who had >10% burned body surface area was 11.9±9.5 (p=0.26). The length of ICU stay for the <10% and >10% burned body surface area patients was 7.0 days (5.0-10.0 days) and 23.0 days (11.5-25.5 days) (p<0.001), respectively., Conclusions: We conclude that burn patients with inhalation injuries have different courses of disease, which are mainly determined by the percentage of burned body surface area., (Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.)
- Published
- 2016
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