12/5/2023 0 Comments Cyanide antidote kit price![]() Army Institute of Surgical Research in San Antonio, Texas. The classic paper describing the effects of inhalation injury, and its principle complication, pneumonia, on mortality in burn patients comes from Shirani, Pruitt, Mason, and the U.S. We will review pathology, diagnostic options and medication strategies. Unfortunately, a consistent diagnostic strategy is unavailable and treatment is largely supportive. ![]() Combined with cutaneous burns, inhalation injury increases fluid resuscitation requirements, incidence of pulmonary complications and overall mortality of thermal injury. Even in isolation, inhalation injury can be associated with longstanding pulmonary dysfunction. Respiratory injury resulting from inhalation of smoke or chemical products of combustion is associated with significant morbidity and mortality. Until the value of these and other approaches is confirmed, however, the clinical approach to inhalation injury is supportive. Medical strategies under investigation for specific treatment of smoke inhalation include beta-agonists, pulmonary blood flow modifiers, anticoagulants and antiinflammatory strategies. Even diagnostic criteria are not consistently applied though bronchoscopy is one diagnostic and therapeutic tool. Consistent international support for this therapy is lacking. Data from European centers supports application of specific antidotes for cyanide toxicity. A number of antidote strategies have been evaluated to address tissue hypoxia associated with cyanide exposure. Cyanide is another toxin produced by combustion of natural or synthetic materials. Unfortunately, data to date do not support application of hyperbaric oxygen in this population outside the context of clinical trials. Hyperbaric oxygen treatment has been evaluated in multiple trials to manage neurologic sequelae of carbon monoxide exposure. Management of toxin exposure in smoke inhalation remains controversial, particularly as related to carbon monoxide and cyanide. Morbidity associated with inhalation injury is produced by heat exposure and inhaled toxins. Improvements in mortality from inhalation injury are mostly due to widespread improvements in critical care rather than focused interventions for smoke inhalation. Many of the consequences of smoke inhalation result from an inflammatory response involving mediators whose number and role remain incompletely understood despite improved tools for processing of clinical material. Injured pulmonary tissue must be protected from secondary injury due to resuscitation, mechanical ventilation and infection while host repair mechanisms receive appropriate support. Burned cutaneous tissue may be excised and replaced with skin grafts. Inhalation injury is a more complex clinical problem. Several factors explain slower progress for improvement in management of patients with inhalation injury. While many products and techniques have been developed to manage cutaneous thermal trauma, relatively few diagnosis-specific therapeutic options have been identified for patients with inhalation injury. Lung injury resulting from inhalation of smoke or chemical products of combustion continues to be associated with significant morbidity and mortality.
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