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Das Inhalationstrauma bei Verbrennungspatienten: Diagnostik und Therapie

Inhalation injury in burn patients: diagnosis and therapy

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Intensivmedizin und Notfallmedizin

Summary

Inhalation injury/trauma of the lung (IHT) provides a variable picture of the consequences from the complex array of harmful gases. Approximately 30% of burn patients suffer from accompanying inhalation injury that negatively effect the prognosis of burn injuries. Presented in this survey work will be diagnosis of and therapy for thermal and chemical IHT. The physiological effects of carbon monoxide and cyanide (HCN) as well as the symptoms and therapy for inhalation poisoning will be examined. Therapy for and prognosis of different forms of IHT will be described. A severe IHT leading to cutaneous burns can result in adult respiratory distress syndrome (ARDS). The present state of respiratory therapy for burn patients with concomitant IHT will be discussed in this context.

Zusammenfassung

Das Inhalationstrauma (IHT) der Lunge bietet ein variables Erscheinungsbild als Folge der Komplexität der verschiedenen schädigenden Rauchgase. Etwa 30% der Verbrennungspatienten erleiden ein begleitendes Inhalationstrauma, welches die Prognose des Brandverletzten erheblich verschlechtert.

In dieser Übersichtsarbeit werden Vorkommen, Diagnostik und Therapie des thermischen und des chemischen IHT dargestellt. Die physiologischen Wirkungen von Kohlenmonoxid (CO) und Cyanid (HCN) sowie Symptome und Therapie der systemischen Inhalationsvergiftung mit diesen Substanzen werden erläutert.

Die Therapie und die Prognose der verschiedenen Formen des IHT werden beschrieben. Ein schweres IHT begleitend zur kutanen Verbrennung kann ein ARDS (adult respiratory distress syndrome) hervorrufen. In diesem Zusammenhang wird der aktuelle Stand der Respiratortherapie bei dem Verbrennungspatienten mit IHT diskutiert.

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  1. Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Ludwig-Guttmannstr. 13, 67071, Ludwigshafen, Germany

    U. Hoppe & R. Klose

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  1. U. Hoppe
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Serie: Die Notfalltherapie und Intensivtherapie beim Verbrennungstrauma Herausgegeben von B. Hartmann (Berlin)

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Hoppe, U., Klose, R. Das Inhalationstrauma bei Verbrennungspatienten: Diagnostik und Therapie. Intensivmed 42, 425–439 (2005). https://doi.org/10.1007/s00390-005-0611-z

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