Learning objectives
To demonstrate the combination of specific lesions of the respiratory tract due to thermal,
inhalation and chemical damage and non-specific changes caused by multiple trauma and sepsis.
To show the importance of CT imaging in patients with ECMO support.
Background
Thermochemical injury results from direct damage to the respiratory tract by flame,
hot gases,
steam and toxic products of combustion.
Damage to the respiratory tract during a fire accident is caused by many factors,
including:
- burn injuries from direct contact with the flame,
high-temperature objects,
hot air;
- inhalation of smoke and toxic products of combustion,
such as carbon monoxide,
carbon dioxide,
hydrogen cyanide,
hydrogen chloride,
etc.;
- damage to the chest as a result of mechanical injuries (fractures of the bone structures of...
Findings and procedure details
In 2018,
the emergency department of our center received 5 patients: 2 patients suffered injuries in a fire,
2 due to an explosion of utility gas indoors.
All the patients were male,
their age ranging from 31 to 50.
The anamnestic data of the four patients included flame burns,
with the involvement of 20 to 90% of skin area,
and one patient had barotrauma.
At admission,
four of the patients had unassisted shallow breathing.
One patient had oxygenation provided with a pre-installed veno-venous ECMO system....
Conclusion
Multislice Helical CT investigation in patients with thermochemical inhalation injury is of critical importance; it allows to determine the amount of damage to the respiratory tract within the shortest period,
to identify the concomitant traumatic and systemic pathology.
A CT scan is necessary for patients with ECMO support in order to determine whether the cannulas were installed properly and for exception possibility of recirculation between venous cannulas of ECMO,
as well as for timely identification of possible specific complications.
Personal information
Sergey Parvanian,
Head of the Department of Anesthesiology and Intensive Care
Daniil Shelukhin,
PhD Med.
Sci.,
Head of Department of Anesthesiology and Intensive Care
Olga Krotova,
MD,
PhD,
Department of Emergency Radiology
Viktor Lishenko,
Department of Thoracic Surgery
David Zaitzev Department of Thoracic Surgery
Arthur Panov,
Department of Plastic Surgery
References
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Banfi,
M.Pozzi,
N.Siegenthaler et al./ Veno-venous extracorporeal membrane oxygenation: cannulation techniques// J.
of Thoracic Disease Vol 8,
No12
2.P.F.
Walker,
M.F.
Buehner,
L.A.
Wood et al./ Diagnosis and management of inhalation injury: an updated review// Crit Care,
2015; 19:351
3.
D.
Shelukhin,
A.
Pavlov,
A.
Ershov/ Extracorporeal membrane oxygenation in patients with severe respiratory failure and the first experience of its use during medical aircraftevacuation in Russia.// Medico Biological and Socio Psychological Problems of Safety in Emergency Situations,
2015 No 3,
p.24-34
4.
Cheol-Hong...