SUCCESSFUL MANAGEMENT OF PATIENT OF INHALATIONAL INJURY INDUCED ARDS

Background: Involvement in fire accidents can be associated with inhalational injury resulting from inhalation of smoke or chemical products of combustion, which can further lead to ALI and ARDS Here we present a case of successful management of a 22 year old patient who suffered from CO poisoning with inhalational injury induced ARDS.

Case Description: A 22-year-old male came in with alleged history of involvement in a fire accident at a hotel. Initially suspected of having CO poisoning along with severe acute lung injury and acute respiratory distress syndrome. Patient was initially managed on HFNC but shifted to IMV and managed according to ARDS protocol. Over a period of 12 days, we were able to successfully treat him and move him out of the ICU.

Discussion and Conclusion: Treatment of CO poisoning is established as immediate removal of victim from the exposure and administration of high flow 100% O2. Since, there is no single management protocol for inhalational injury, this case was treated as per ARDS management protocol with bronchoscopy and bronchoalveolar lavage, which helped in significantly improving the patient’s oxygenation status and earlier recovery than expected. Hence, we hypothesize that employment of early bronchoscopy and bronchoalveolar lavage helps in accelerating the recovery of patients suffering from inhalational injury induced ARDS.