Chemical pulmonary burn injury and chemical intoxication.

Two large groups of patients with chemical pulmonary burns who sustained their injuries in the same environment were presented. Data from the blaze smoke analysis of two imitative experiments which were performed under the same conditions as were present when these patients sustained their burns showed a high concentration of carbon monoxide of 35700-571400 ppm and multivariable components of chemicals. The environmental conditions, the clinical course, laboratory findings and blaze analysis clearly demonstrated the close relationship between chemical pulmonary burn injury and chemical intoxication which increased the difficulty in treatment. Ideally, the initial treatment at the site of the fire is the application of 100 per cent oxygen in high flow by mask, and temporary artificial hyperventilation after hospitalization will give a satisfactory result if the fire victim suffers severe carbon monoxide poisoning. In order to treat chemical intoxication in the patient with chemical pulmonary burns successfully, we have adopted a regimen of 'over-loading fluid resuscitation', together with diuretics and positive end expiratory pressure (PEEP) under the monitoring of central venous pressure.