ETIOLOGY AND CONSEQUENCES OF RESPIRATORY-FAILURE IN THERMALLY INJUREDPATIENTS

Inhalation injury predisposes burn patients to pneumonia, respiratory failure, and death, but the incidence and consequences of respiratory failure in the absence of inhalation injury are not well known. In a r eview of 529 burn patients admitted over a 4-year period, patients wit h inhalation injury had a 73% incidence of respiratory failure (hypoxe mia, multiple pulmonary infections, or prolonged ventilator support) a nd a 20% incidence of adult respiratory distress syndrome (ARDS). In p atients without inhalation injury, respiratory failure developed in 5% of patients and ARDS in 2% (both p <0.001). Patients with respiratory failure display a high incidence of multiple organ failure and mortal ity (27% to 50%), regardless of the presence of inhalation injury. AU patients who died had multiple organ failure. This review demonstrates that respiratory failure, regardless of its cause, frequently leads t o multiple organ failure and death. Inhalation injury, in the absence of respiratory failure, does not appear to contribute to mortality.