Pharmaco-management of inhalation injuries for burn survivors

BACKGROUND: Burn injury is exacerbated by inhalation injury, causing higher morbidity and mortality rates compared to those with a comparable burn injury alone. The complex pathophysiology of inhalation injury is well described, but analysis of treatment is a mammoth task and requires individual focus on a number of components of management. In this case, the focus of the review is treatment of inhalation injury using pharmacological means. It provides a concise overview of the disease process and a summary of the evidence for specific manipulation of various disease pathways. METHODS: A literature search through PubMed was completed and all links and bibliography reference articles were explored. RESULTS: A total of 47 papers matched the search terms. Of these, one was a comparative study with historical controls, 2 were retrospective case series, 2 studies reported a single human case series, 34 were examinations in animals, and 8 were expert opinion or reviews. CONCLUSION: The literature illustrates the complicated immunobiochemical pathways that have conflicting roles and importance, complicating integrated understanding. Secondly, there is an almost complete absence of high quality data from humans. Clinical use of pharmaco-therapies for inhalation injuries is further limited by the lack of commercial availability.