Hydrogen cyanide is produced by combustion of wool, silk, polyurethane foam and phenol resins found in home construction. The organic aldehydes produce a chemical pneumonitis by direct irritation of the tracheobronchial tree. These patients must be followed for development of bronchiolitis obliterans. Occurs between 0 and 20 hours. Severe bronchospasm and alveolar damage with disruption of the alveolar capillary membrane characterized this phase.
Pulmonary resistance is increased while compliance is decreased.
Arteriovenous shunting produces a progressive hypoxia. Etiology secondary to pulmonary burn, over hydration, and cardiac pathology. Staph and pseudomonas are offenders. Nelson et al 1957 Give broad endorsement to tracheotomy in burn setting. Eckhauser 1977 Suggest to avoid tracheotomy at all costs.