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Indications for Tracheal Intubation in Patients with Thermal Injury
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- Nagai Seri
- Department of Otolaryngology, Nagoya Second Red Cross Hospital
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- Hamajima Yuki
- Department of Otolaryngology Head and Neck Surgery, Nagoya City University
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- Suzuki Motohiko
- Department of Otolaryngology Head and Neck Surgery, Nagoya City University
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- Kimura Toshio
- Kimura ENT Clinic
Bibliographic Information
- Other Title
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- 上気道型気道熱傷における気管挿管の適応基準
- ジョウキドウガタ キドウ ネッショウ ニ オケル キカンソウカン ノ テキオウ キジュン
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Description
Smoke inhalation divides into two types: thermal injury to the upper airway and chemical injury to the lung parenchyma. In thermal injuries, within two days laryngeal edema can become a problem and intubation is needed to prevent dyspnea. In chemical injuries, ventilation failure due to gas exchange can become a problem within two to three days. For thermal injuries, no criteria exist concerning intubation, and there have been few reports about the relationship between upper airway findings and laryngeal edema. Here, we discuss the relationship between the soot site and laryngeal edema, and factors affecting the progress of laryngeal edema in thermal injuries. Between April 2008 and March 2014, 47 patients were admitted to Nagoya Red Cross Hospital due to burn and inhalation injury. All patients underwent laryngeal fiberscopy within 24 hours after injury. Based on upper airway findings (site of soot), we divided the patients into four groups: Group 1 (n=9) : no soot in upper airway and no laryngeal edema; Group 2 (n=7) : soot in the naso-oropharynx and no laryngeal edema; Group 3 (n=14) : soot in the larynx and trachea and no laryngeal edema; Group 4 (n=17) : laryngeal edema. The results revealed no relationship between the soot site and laryngeal edema progression. The burn index and burn area are significantly important to progressive laryngeal edema. Conclusion: In case of thermal injury, preventive intubation will be recommended due to burn index and burn area and prognostic hypoprotein plasma, even if there is no laryngeal edema. Conclusion: In case of thermal injury, preventive intubation will be recommended due to burn index and burn area and prognostic hypoprotein plasma, even if there is no laryngeal edema.
Journal
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- Nihon Kikan Shokudoka Gakkai Kaiho
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Nihon Kikan Shokudoka Gakkai Kaiho 66 (3), 203-207, 2015
The Japan Broncho-esophagological Society
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Details 詳細情報について
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- CRID
- 1390001205014967552
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- NII Article ID
- 130005083876
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- NII Book ID
- AN00187474
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- ISSN
- 18806848
- 00290645
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- NDL BIB ID
- 026549663
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL Search
- Crossref
- CiNii Articles
- OpenAIRE
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- Abstract License Flag
- Disallowed
