Management of inhalation injury and respiratory complications in Burns Intensive Care Unit

BACKGROUND
Inhalation injury has high mortality and carries a significant risk of permanent pulmonary dysfunction. Inhalation injury and its consequences impose difficulties for the respiratory therapists, nurses and doctors who play a central role in its clinical management. In this study, we aimed to report our clinical experience and the role of non-invasive mechanic ventilatory (NIMV) support in a series of inhalation-injured patients.
METHODS
Patients hospitalized at Ankara Numune Training and Research Hospital’s Burns Intensive Care Unit between March 2009 and March 2011 was reviewed, and patients with required respiratory support due to inhalation injury were included in the study.
RESULTS
Among the patients, 37 had inhalation injury, and their mortality was 13.5%. Of the 37 patients, 16 had mandatory intubation (6 in the first 6 hours and 10 in the clinical course); however, others (67.8%) had only NIMV support.
CONCLUSION
Application of NIMV support with proper modes decreases the need for invasive procedures in inhalation-injured patients. Based on our results, we propose the application of NIMV support in inhalation-injured burn patients.

Yanýk yoðun bakým ünitesinde inhalasyon yaralanmasý ve solunum komplikasyonlarýnýn yönetimi

AMAÇ
Ýnhalasyon yaralanmasý yüksek mortalite oranlarýna sahiptir ve belirgin kalýcý pulmoner fonksiyon bozukluðu riski taþýmaktadýr. Ýnhalasyon yaralanmasý ve sonuçlarý, klinik yönetiminde ana rol oynayan solunum terapistlerine, hemþirelere ve doktorlara ciddi zorluklar oluþturur. Çalýþmamýzda inhalasyon yaralanmalý hasta serimizdeki klinik tecrübelerimizi ve noninvazif mekanik ventilatör (NIMV) desteðinin rolünü bildirmeyi amaçladýk.
GEREÇ VE YÖNTEM
Ankara Numune Eðitim ve Araþtýrma Hastanesi Yanýk Yoðun Bakým Ünitesi’nde Mart 2009 - Mart 2011 yýllarý arasýnda yatarak tedavi alan hastalardan inhalasyon hasarý nedeniyle solunum desteðine ihtiyaç duyanlar çalýþmaya alýndý.
BULGULAR
Bu hastalarýn 37’sinde inhalasyon yaralanmasý vardý, mortalite oraný %13,5 olarak bulundu, hastalarýn 16’sýnda zorunlu entübasyon uygulanýrken (altý hastada ilk 6 saatte ve 10 hastada klinik seyir sürecinde) diðer hastalara sadece (%67,8) NIMV desteði uygulandý.
SONUÇ
NIMV desteðinin uygun modlarda uygulanmasý, inhalasyon yaralanmalý olgularda invaziv yöntemlerin gerekliliðini azaltmaktadýr. NIMV desteðinin inhalasyon yaralanmalý yanýk hastalarýnda uygulanmasýný önermekteyiz.