ABSTRACT
Carbon monoxide (CO), one of the major products of combustion, when associated with inhalation injury may reach lethal levels. This chapter discusses the other products of combustion, including cyanide, aldehydes, acrolein, and hydrogen fluoride. Inhalation injury is characterized by progressive inflammatory changes that result in deterioration of pulmonary function and structure. One of the primary determinants of survival following burn trauma is smoke inhalation injury. Direct thermal injury usually occurs immediately, and it causes edema, erythema, hemorrhage, and ulceration of the airway. The changes in pulmonary transvascular fluid flux seen with inhalation injury are markedly reduced by the administration of cyclooxygenase and thromboxane synthesis inhibitors. Injury to tracheobronchial areas depends upon the gaseous and particulate content of the inhaled material. Acrolein has been found to be present in higher concentrations relative to its toxicity than other compounds. Acrolein is a low molecular weight a,b-unsaturated aldehyde that exists in high concentrations in smoke from wood, cotton, and polyethylene.
