Hyperbaric oxygen therapy for acute smoke inhalation injuries

Patients with acute thermal burns often have pul monary injuries secondary to the inhalation of super heated gases and toxins. For victims trapped in closed spaces, the likelihood of such injuries is increased. In halation of steam causes edema and closure of the upper airway, while inhalation of smoke and hot, dry gas injures the pulmonary parenchyma. Combustion of hydrocarbons generates toxic by-products, such as carbon monoxide and cyanide, causing additional pul monary injuries and tissue asphyxia. Some of these in juries can benefit from hyperbaric oxygen therapy. Hyperbaric oxygen therapy is defined as ventilation with 1 00% oxygen at pressures greater than those found at the earth’s surface. By virtue of its vasocon strictive properties, hyperbaric oxygen is beneficial to smoke-injured pulmonary tissue. It has been shown to reduce extravascular lung water by 20% in experimen tally induced thermal inhalation injuries.’ Other reports show a reduction in respiratory morbidity in burn pa tients treated with hyperbaric oxygen. 24 It is considered the primary therapy in cases of carbon monoxide in toxication and is proving a useful adjunct in treating cyanide poisoning.