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Pharmaco-management of inhalation injuries for burn survivors

Authors Anthony C Bartley, Dale W Edgar, Fiona M Wood

Published 8 January 2008 Volume 2008:2 Pages 9—16



Anthony C Bartley1, Dale W Edgar2, Fiona M Wood3

1Medical Officer, Royal Perth Hospital Burns Unit, Burns Service of Western Australia; 2McComb Clinical Researcher, Senior Physiotherapist, Burns Service of Western Australia, Curtin University of Technology; 3Director, Burns Service of Western Australia, McComb Foundation of WA, University of Western Australia, Perth, Australia

Background: Burn injury is exacerbated by inhalation injury, causing higher morbidity and mortality rates compared to those with a comparable burn injury alone. The complex pathophysiology of inhalation injury is well described, but analysis of treatment is a mammoth task and requires individual focus on a number of components of management. In this case, the focus of the review is treatment of inhalation injury using pharmacological means. It provides a concise overview of the disease process and a summary of the evidence for specific manipulation of various disease pathways.

Methods: A literature search through PubMed was completed and all links and bibliography reference articles were explored.

Results: A total of 47 papers matched the search terms. Of these, one was a comparative study with historical controls, 2 were retrospective case series, 2 studies reported a single human case series, 34 were examinations in animals, and 8 were expert opinion or reviews.

Conclusion: The literature illustrates the complicated immuno-biochemical pathways that have conflicting roles and importance, complicating integrated understanding. Secondly, there is an almost complete absence of high quality data from humans. Clinical use of pharmaco-therapies for inhalation injuries is further limited by the lack of commercial availability.

Keywords: inhalation injury, smoke, burns, inhalation, medication