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Inhalation Injury

Discussion in 'Anesthesiology' started by IceDoc, May 17, 2007.

  1. IceDoc

    IceDoc Junior Member
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    Question: How long do you wait to extubate after an inhalation injury (assuming the patient meets all usual extubation criteria, and there is no other indication for keeping him/her intubated other than a history of smoke inhalation)?

    Had a case recently in the unit of a 12yo with smoke inhalation (no burns on body). He met all usual extubation criteria (including a good leak), and was an easy intubation. Upon extubation, he was immediately stridorous. We limped through (actually HE limped through, WE just sweated) with all the usual (epi neb, bipap etc) and all was eventually good. But at the time I certainly was wishing we'd left the tube in.
     
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  3. Planktonmd

    Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

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    It sounds your patient had Laryngospasm on extubation probably not related to his smoke inhalation.
     
  4. Mman

    Mman Senior Member
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    A smoke inhalation injury with no burns? It's my recollection that in burn patients with significant airway injury you leave them tubed for a while (1-2 days) while their upper airway edema sorts itself out. I'm not quite sure about just an inhalational smoke injury that wasn't bad enough to cause any visible burns to the face.
     
  5. Noyac

    Noyac ASA Member
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    How long after the burn was the extubation?
     
  6. IceDoc

    IceDoc Junior Member
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    Possibly. A lot of secretions that could have caused laryngospasm were suctioned. However, it didn't have that same squeaky quality I've usually heard. Regardless, the obstruction was clearly glottic or above.
     
  7. Noyac

    Noyac ASA Member
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    I doubt that the sqeaking would have been present with the edema in the area. I think laryngospasm is highly likely.
     

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