Table 2.

Historic progression of known physiologic changes in smoke injury

• Volatile products in smoke leading to early and late respiratory distress

• Airways edema leading to early destruction and later airways plugging

• Use of blood gases to assess the exchange of gases and critical care to stabilize lung physiology

• Ventilatory support to stabilize physiologic changes

• Concept of tracheobronchitis and alveolitis impairing ventilation and gas exchange

• Adult respiratory distress syndrome, alveolar edema and collapse, surfactant deficiency, increase in shunting

• Role of airways inflammation and mediators on the physiologic changes with smoke inhalation