What is the role of pulmonary function testing (PFT) in the workup of smoke inhalation injury?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Perform baseline pulmonary function tests (PFTs) once the patient is stable. In the ED, serial peak flow readings may be helpful. Later, PFTs allow evaluation and comparison of lung function and reversibility with bronchodilators and potentially steroids. If the patient develops dyspnea on exertion, then perform PFTs with exertion if PFTs at rest cannot explain the symptoms.

Pulmonary function test results become abnormal soon after inhalation injuries. Vital capacity, pulmonary compliance, and functional residual capacity are reduced. In patients with bronchospasm, forced expiratory volume in 1 second (FEV1), peak flow, and midexpiratory flow rates are reduced. Diagnostic accuracy is 91%.

In patients with cutaneous burns, the reduction in vital capacity and FEV1 correlates closely with the extent of surface burns. Full resolution of pulmonary function test result abnormalities may take several months. Some agents, particularly chlorine gas, may result in reactive airways syndrome, with subsequent development of airflow obstruction.


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