Prognosis
Owing to the broad spectrum of clinical disease, the prognosis and natural course of inhalation injury is highly variable. Mortality from the most common source of inhalation injury, smoke inhalation, is estimated to be 5% to 8%.[48] Among survivors, disease sequelae depend upon the type of injury suffered.
Upper airway disease
Resolution of upper airway symptoms depends on the severity of injury as well as on comorbid conditions, which may promote oedema and prevent healing. Patients with significant upper airway disease may develop chronic rhinitis, sinusitis, pharyngitis, laryngitis, and vocal cord dysfunction, and demonstrate heightened sensitivity to future environmental exposures.[10] As in any condition, patients who require prolonged intubation are at risk for tracheal stenosis as well as tracheomalacia.
Carbon monoxide poisoning
Prognosis in carbon monoxide poisoning is highly variable. Survivors commonly have neurocognitive symptoms that may begin acutely and persist or develop after some delay and resolution of carboxyhaemoglobin (CO-Hb) elevation.[29] Symptoms persisting beyond 1 month occur in up to 50% of patients with significant exposure (loss of consciousness, CO-Hb >25%).[29]
Lower airways disease
Resolution of airflow obstruction is dependent upon the severity of injury, although some patients have persistent symptoms (tracheitis and bronchitis) beyond the acute illness.[10] The reactive airways disease syndrome is a known sequela of inhalational injury.[49]
Acute respiratory distress syndrome (ARDS)
Patients who suffer ARDS have a high mortality, and the majority do not recover normal lung function even after 1 year.[50]
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