Smoke Inhalation Injury of Indoor Fire

Abstract

In Brief Smoke inhalation injury can be considered as a systemic disease. Early mortality and systemic involvement are due to the severity of thermal injury of the upper airway and to CO poisoning associated with other combustion materials. Prompt administration of 100% oxygen therapy is crucial. Laryngoscopy is useful because it may show pharyngeal or laryngeal mucosal injury despite the absence of respiratory symptoms and consequently the need for endotracheal intubation. Bronchoscopy is useful in identifying severity of airway injury and performing bronchial toilet and BAL culture, thus allowing early diagnosis of pulmonary infections and the adjustment of antibiotic treatment. Corticosteroid therapy should be considered when persistent acute respiratory distress syndrome, interstitial pneumonia, or obliterans bronchiolitis is suspected without evidence of active infection. Obstruction airway disease can persist several months after the smoke inhalation. Smoke inhalation is a major cause of fire-related morbidity and mortality accounting for several thousand deaths annually in different countries. This review describes the respiratory and systemic involvement and some pathophysiology aspects over which treatment strategies should be planned.