Pathology of the Lung in Fatally Burned Patients

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Abstract
A clinicopathological examination of 233 autopsies was performed to analyze the frequency of fatal complications following cutaneous thermal injury with particular reference to pulmonary complications. Over a 6-yr. period, the major fatal complication in burned patients has shifted from invasive burn wound infection to pneumonia. The decline in burn wound infection was due to effective topical chemotherapy. The recent increase in deaths attributed to pneumonia is considered real in patients over 15 yr. of age and results from the greater frequency of infective lower respiratory disease found clinically. A part of the increase in deaths attributed to pneumonia may be due to effects of earlier and more prolonged ventilatory assistance and O2 therapy. The majority of laryngeal and tracheal lesions found at autopsy appear due to repeated trauma from tracheostomies or endotracheal tubes. Respiratory complications occur more frequently in patients with facial burns, but the presence of facial burns alone does not constitute a particular hazard to the burned patient. The increased incidence of respiratory complications in patients with facial burns, may be due to the increased occurrence of facial burns in severely burned patients who are more susceptible to infective lower respiratory disease. Respiratory complications in less severely burned patients with facial burns have not occurred.

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