Radiographic manifestations of acute smoke inhalation.

Acute smoke inhalation may lead to serious pulmonary injury and contribute significantly to mortality of fire victims. The chest radiographic findings in 21 patients with acute smoke inhalation are analyzed, and possible pathophysiologic mechanisms responsible for the radiographic abnormalities noted are discussed. Patients with surface injury burns were intentionally eliminated from this study. Our findings indicate that the standard chest radiograph is an insensitive means of determining pulmonary injury by smoke inhalation. The importance of blood carboxyhemoglobin levels and arterial blood gas determinations in the clinical evaluation of patients with acute smoke inhalation is stressed.