Cases reported "Burns, Inhalation"

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1/22. Electrocautery-ignited endotracheal tube fire: case report.

    The risk of fire in the airway associated with laser surgery is well known, but there are reports of endotracheal tube fires ignited by electrocautery, particularly during pharyngeal surgery or tracheostomy or both. This uncommon complication has potentially devastating consequences. Surgeons undertaking these procedures should be aware of this complication and be familiar with measures to avoid them. We present a case report of an electrocautery-ignited endotracheal tube fire during an elective tracheostomy, which resulted in the patient's death.
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2/22. Complete fusion of the vocal cords; an unusual case.

    A case is presented of a woman who sustained a 35% body surface area mixed depth cutaneous burn, together with a significant inhalational injury. The patient required emergency resuscitation with endotracheal intubation and subsequently tracheostomy. This resulted in an unfortunate complication of a total adhesion between the vocal cords which extended into the subglottic area, causing complete occlusion of the airway.
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3/22. Airway fire due to diathermy during tracheostomy in an intensive care patient.

    We describe a case of airway fire in an 83-year-old, critically ill patient. The fire occurred during a surgical tracheostomy under general anaesthesia, following ignition of the tracheal tube by diathermy. After debridement of the burnt tissue and treatment with intravenous antibiotics and glucocorticoids, the patient's respiratory function worsened initially. The patient eventually recovered without long-term sequelae and was discharged from the intensive care unit. The circumstances of this and other similar incidents are reviewed, as are the suggested methods for preventing this frightening occurrence.
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keywords = airway
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4/22. Mass ammonia inhalational burns--experience in the management of 12 patients.

    Twelve Korean crew members of a deep sea fishing vessel were admitted to the burns Centre, singapore General Hospital following exposure to ammonia gas. The injuries sustained were primarily respiratory burns with minor cutaneous and corneal burns. They were divided into three grades of severity based on the admission findings and subsequent clinical course. Management was according to a standard respiratory burns protocol. Eight patients were intubated. Ten of the patients with mild and moderate involvement of the respiratory tract recovered without complication. Of the two patients with severe respiratory burns, one died while another progressed to chronic debilitating airway disease.
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5/22. Long-term management of extensive tracheal stenosis due to formic acid chemical burn.

    We report on a 26-year-old woman who during early infancy (6 months) suffered from a chemical burn of the skin and upper airways due to spill of formic acid powder. Twenty years after the initial injury, she presented with dyspnea and stridor due to severe tracheal stenosis. Several interventional bronchoscopic manipulations were initiated: incision of the stenotic lesion with Nd:YAG laser and dilatation with a valvuloplasty balloon which enabled silicone stent placement which was subsequently kept in place for 3 years. Complications during the 4th year after stenting led to the successful replacement of this stent by two autoexpandable metallic stents covering the total length of the trachea from the subglottic area to the carina. In post-burn inhalation injuries, a complex inflammatory process may be active for many years after the initial insult. These injuries respond to prolonged tracheal stenting and a conservative approach is recommended.
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keywords = airway
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6/22. Case with bromine exposure leading to respiratory insufficiency.

    A 21-year-old male had a chemical burn on the right forearm when he inadvertently spilled bromine during an experiment. Since he inhaled vaporized bromine and had dyspnea and pharyngalgia, he arrived at our hospital in an ambulance as an emergency patient. On arrival, he kept a clear consciousness with a pulse rate of 98, body temperature of 36.8 degrees C, blood pressure of 132/80 mmHg, respiratory rate of 25, and oxygen saturation of 100%. (10 L/min of oxygen were administered.) He had marked dry coughs. His clothes had a foreign odor with mucosal irritation. Arterial blood gas analysis and blood biochemistry were normal. Based on these findings, he was diagnosed with chemical airway damage and bulbar conjunctiva from the exposure to bromine and a chemical burn on the right forearm. His respiratory condition became worse after admission, resulting in pulmonary edema. He was endotracheally intubated and controlled with an artificial ventilator on Day 3 after his injury. He was continuously treated with steroids and sivelestat sodium hydrate, which gradually improved his respiration. He was released from the artificial ventilator and extubated on Day 7. Although dyspnea associated with body movement and hoarseness persisted after extubation, the symptoms decreased and he was discharged on Day 41. This rare case is worth attention because serious respiratory insufficiency requiring artificial ventilation due to pulmonary edema from bromine exposure has not been reported in japan.
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7/22. Endotracheal tube ignition by electrocautery during tracheostomy: case report with autopsy findings.

    This case of upper airway tract fire resulting from the use of electrocautery during elective tracheostomy has significance for surgeons, anesthetists, and forensic pathologists alike. The major autopsy findings are described and illustrated. Suggestions that may help to prevent or minimize the risk of fire in this context are reviewed.
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keywords = airway
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8/22. Treatment of combined subglottic and critically low tracheal stenoses secondary to burn inhalation injury.

    We report a case of combined severe subglottic and lower tracheobronchial stenoses after an inhalation burn injury. The patient was successfully treated by the insertion of a bifurcated silicone rubber stent. The proximal limb of the silicone tube was used to stent the subglottic stenosis after it had been resected, a treatment option not previously reported. It is speculated that the diffuse airway damage resulted from a combination of thermal injury, mechanical trauma and infection. The relatively late symptomatic presentation of the lower tracheal stricture is stressed and the treatment options discussed.
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keywords = airway
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9/22. Clinical and laboratory features of acute sulfur dioxide inhalation poisoning: two-year follow-up.

    We present clinical and laboratory results (including nuclear imaging) obtained over a period of two years in two nonsmoking miners who were exposed to high concentrations of sulfur dioxide (SO2) after a mine explosion. Within 3 wk of the accident, both miners had evidence of severe airways obstruction, hypoxemia, markedly reduced exercise tolerance, ventilation-perfusion mismatch, and evidence of active inflammation as documented by positive gallium lung scan. Serial ventilation-perfusion scans over the first 12 months showed progressive improvement without returning to normal. After the initial recovery, there has been no significant change over the subsequent two years postinjury. Pulmonary function and exercise tests also displayed a similar pattern of initial improvement. We conclude that (1) acute exposure to high concentrations of SO2 results in severe airways obstruction, (2) pulmonary function abnormalities are partially reversible, and (3) most of the improvement occurs within 12 months after the initial injury.
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ranking = 2.0893599387861
keywords = airway, obstruction
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10/22. Airway complications from free-basing cocaine.

    The majority of the deaths due to fires result from smoke inhalation, hypoxia, and systemic toxicity. Lower airway injury from chemical byproducts carried in the smoke is less frequent and thermal injury to the lower airways is a rare occurrence. We report a case of severe thermal injury to the conducting airways due to either inhalational injury or to intratracheal ignition of the ether vehicle used in free-basing cocaine resulting in severe reactive airways disease and tracheal stenosis requiring reconstructive surgery.
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keywords = airway
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