Respiratory Effects of Short-Term, High-Intensity Toxic Inhalations: Smoke, Gases, and Fumes

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Abstract
Respiratory insufficiency resulting from inhalation of hot air, smoke, or toxic gas is a common cause of death in fire victims. Toxic gas inhalation in settings other than fires is a less common but still important cause of death and disability. Pulmonary inhalation injury and systemic intoxication from exposure to a variety of agents are discussed with regard to their pathogenesis, pathophysi ology, diagnosis, and treatment. Upper airway obstruc tion and noncardiogenic pulmonary edema are the life- threatening respiratory complications in the immediate postinhalation period. Carbon monoxide and hydrogen cyanide intoxication are frequently associated with in halation injury in fire victims. Early recognition and treatment of inhalation injury and systemic intoxication in victims of fires and industrial and environmental acci dents could well result in improved survival.