Abstract
Inhalation injury is a major cause of morbidity and mortality in patients with burns. Presence of airways injury adds to the need of fluid supplementation, increases risk of pulmonary complications. Due to many mechanisms involved in pathophysiology the treatment is complex. Among them the formation of fibrin casts inside airways constitutes a prominent element. The material residing in tracheobronchial tree causes ventilation-perfusion mismatch, complicates mechanical ventilation, provides a medium for bacterial growth. Many studies of animal models and single centre human studies investigated inhaled anticoagulation regimens employing heparin in management of inhalation injury. Simultaneously safety, especially in connection with possible bleeding risk, was the subject of research. The results suggest positive impact on treatment results, with low risk of side effects. This paper revise the available clinical data on inhaled heparin use in patients with burns.
Highlights
Inhalation injury is an independent risk factor contributing to high mortality in patients with burns [1,2,3]
A risk of airways injury increases with total body surface affected by the burn
According to the data from the United States, a burn of 20% of total body surface area corresponds to a 2.2% chance of inhalation injury
Summary
Inhalation injury is an independent risk factor contributing to high mortality in patients with burns [1,2,3]. A clinically significant inhalation injury can be present despite a lack of cutaneous burns [5]. It is worth noting that inhalation injury in burn patients is connected with higher need for intravenous infusion in comparison to patients without airways damage [24, 25].
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