1160

Abstract

Introduction: Adult respiratory distress syndrome (ARDS) associated with severely burned patients whom attained inhalation injury typically develops within 48-72 hours of the initial insult. Our facility recently treated three victims of a large volume propane explosion with burns averaging 28% total body surface area. While all three patients sustained facial burns and had singed nasal hairs, a detailed initial bronchoscopic evaluation was negative for inhalation injury. All patients were resuscitated using the standard Parkland formula and underwent debridement and grafting within 48 hours. Approximately 6-7 days following the injury, all three patients developed worsening respiratory failure consistent with ARDS with hemodynamic collapse. Bronchoscopic evaluation revealed intense airway edema with mucosal sloughing. In this case series we review the mechanism of propane combustion and how it may have contributed to the clinical course of these patients. Clinicians should be aware of the potential for delayed development of bronchoscopic evidence of inhalation injury and ARDS in patients involved in propane explosions.