Model System:

Burn

Reference Type:

Journal

Accession No.:

J78253

Journal:


Lancet

Year, Volume, Issue, Page(s):

, 388, 10052, 1437-1446

Publication Website:

Abstract:

Article reviews the current understanding of the pathophysiology of smoke inhalation injury, the best evidence-based treatments, and challenges and future directions in diagnostics and management. Smoke inhalation injury is a serious medical problem that increases morbidity and mortality after severe burns. Despite recent advances in critical care and the management of burn patients, smoke inhalation injury continues to increase significantly the morbidity and mortality in burn patients. This is related, it least in part, to the difficulty in reliably grading the severity of inhalation injury and the paucity of evidence-based, generally accepted therapeutic interventions. Clinical trials should be undertaken to address these issues. Basic and preclinical translational studies should focus on determining molecular and cellular mechanisms that underlie both airway and lung parenchymal injury as well as the development of novel treatment approaches including the application of regenerative medicine and bioengineering. The authors recommend that an expert consensus conference be organized in the near future to establish a comprehensive protocol for a large prospective multicenter, ideally multinational, clinical trial. In that trial, the noted gaps in clinical care and pathophysiologic understanding could be definitively addressed to reduce the morbidity and increase the salvage of patients with inhalation injury.

Author(s):


Enkhbaatar, Perenlei, Pruitt Jr., Basil A., Mlcak, Ronald, Wolf, Steven E., Sakurai, Hiroyuki, Herndon, David N.

Participating Centers: