Inflammatory mediators in smoke inhalation injury

Smoke inhalation occurs in 10% to 30% of patients admitted to burn centers, and increases mortality by a maximum of 20% over that predicted by age and extent of cutaneous burn alone. Pneumonia in these patients then further increases mortality by a maximum of 40%. While one estimate suggested that 75% of deaths following burn injury may be accounted for by inhalation injury, more recent cohort studies have suggested there is a decreasing mortality attributable to inhalation injury. As part of understanding and improving outcomes from burn injuries, the pathophysiology and inflammatory processes involved in smoke inhalation injury has been extensively investigated in animal models. This review will emphasize the inflammatory pathways involved in inhalation injury, and targeted methods used to treat this injury in both experimental and human models.