Early and late complications among 15 victims exposed to indoor fire and smoke inhalation

Abstract

Aim To evaluate early and late complications among victims exposed to indoor fire and smoke inhalation. Method An observational, descriptive and prospective longitudinal study of 15 victims of smoke inhalation admitted to the intensive care unit. Results Although without significant burns, 13 of the victims were unconscious, with airway injury, abnormal temperature and hypokalaemia, and underwent mechanical ventilation. Initial carbon monoxide concentration averaged 20.4 ± 8.3%, dropping to 3.9 ± 3.3% 4 h later. On the 1st day, two victims recovered and were transferred, and another two died. Creatine kinase levels (2594 ± 2455 U/l) correlated with duration of intensive care. Of the remaining 11 patients, 10 had early pneumonia. Steroid treatment was initiated for four patients receiving prolonged mechanical ventilation, because of persistent fever and dry cough without evidence of infection. Conclusions Mortality and systemic involvement were related to burn of the upper airway and contact with combustion products. Initial creatine kinase levels emerged as a prognostic marker of injury severity. Bronchoscopy was useful in grading airway injury and obtaining bronchoalveolar culture. Corticosteroids were effective, after the acute phase, in treating non-infectious pulmonary complications.