What is the prognosis of smoke inhalation injury?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Most inhalation injuries are self-limited and resolve within 48-72 hours. The severity of direct pulmonary parenchymal injury depends on the extent of exposure and the type of inhaled toxins produced during combustion. Most patients do not manifest spirometry changes. Rare long-term sequelae include tracheal stenosis, bronchiectasis, interstitial fibrosis, and bronchiolitis obliterans.

The prognosis for mild-to-moderate exposures of toxic smokes is generally very good, with the usual outcome return to full recovery without sequelae. Metal fume fever is self-limited and usually resolves after a short period of observation. Exposure to white smoke (HC) in a military setting can lead to acute lung injury and in severe cases to ARDS. With more severe exposures, lungs may become severely damaged and develop chronic pulmonary fibrosis.

Children with acute pulmonary injury from toxic inhalations generally do well once supported through the initial period of inflammation and damage. Most of the pulmonary damage is self-limited and resolves within 2-3 days. The degree of recovery depends on the extent of the pulmonary parenchymal injury and subsequent hypoxic damage to the organs.

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