Combined smoke inhalation and body surface burns injury does not necessarily imply long-term respiratory health consequences

Abstract

This study was undertaken to assess the long-term respiratory health consequences of smoke inhalation in patients who are burns survivors. Patients with smoke inhalation resulting from domestic flame or fire were studied. Medical records were the primary source for the selection of the patients. Smoke inhalation was diagnosed on the basis of the visual appearance of the airways on the reported bronchoscopy. Patients who participated in the study were compared on important characteristics with those who did not participate. The participants were then assessed by questionnaire, physical examination, chest radiograph and pulmonary function tests. Twenty three out of 45 patients who had survived smoke inhalation participated in the study. Participants and nonparticipants were comparable with respect to gender, age, time since injury, aetiology of injury, and total body surface burned. Participants had more facial burns, more severe bronchoscopic findings of smoke inhalation and required intubation more frequently. Respiratory symptom assessment and pulmonary function tests were performed 45 +/- 23 months after smoke inhalation. Four patients reported an increase in dyspnoea, one an increase in cough and one an increase in phlegm. All the patients had pulmonary function tests and bronchial responsiveness (provocative concentration of histamine resulting in a 20% fall in forced expiratory volume in one second (PC20) > 16 mg.mL-1) within normal limits. The four patients complaining of increased dyspnoea had results within normal limits for cardiac and respiratory variables on maximal exertion. The present study indicates that, in burn patients, smoke inhalation resulting from a single domestic fire does not necessarily imply long-term respiratory health consequences.