Search

The problem of difficult airways remains relevant for many years. Complications associated with unpredictable difficult airways often lead to the lethal outcome or neurological problems. This article analyzes the causes of difficult airways in patients with burns of face and neck. Such patients face a higher risk to develop difficult airways and it is impossible to follow the traditional procedure for maintaining airway patency. The article expresses the opinion about the inability of modern methods for assessing airway patency to predict possible problems associated with tracheal intubation and ventilation of patients with burns of face and neck.

Infections are a common cause of morbidity and mortality in burn patients, and almost 50% of infection-related deaths in burn patients are caused by pneumonia. The proportion of facial and/or neck burns (FNB) in burn centre admissions is high, and these patients have a well known respiratory risk. However, it is not well established in the literature if the occurrence of a FNB is a risk factor for respiratory infection during hospitalization. A retrospective, single-centre trial at the burn unit of the Prelada Hospital was conducted, including patients admitted between January 2011 and December 2014. The primary objective was to investigate the existence of a relation between face and/or neck burns and occurrence of respiratory infection. A total of 229 patients were included in the study, 126 with FNB and 103 without FNB. Higher total body surface area (TBSA) burned, inhalation injury and early endotracheal intubation were statistically more frequent in the FNB group. These variables were also more prevalent in the group that developed respiratory infection during the burn unit stay. Concerning FNB patients, the most frequent microbiological strains isolated in respiratory secretion cultures were Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pneumonia, while in nFNB patients it was Klebsiella pneumoniae. In our population, only early ETI, inhalation injury and higher TBSA appear to be independent risk factors for respiratory infection in FNB patients, although age, male sex and co-morbidities are also known risk factors for respiratory infection in burn patients.