Algorithm for management of pulmonary complications in burn patients

An algorithm for management of pulmonary complications in burn patients on the same basis as in patients with adult respiratory distress syndrome is outlined. Pao2 of less than 60 torr (F102, 0.21–0.4), Paco2 over 40 torr, pH less than 7.35, respiratory rate over 40/min, and clinical evidence of compromised upper airway were the indications for initiation of aggressive intensive respiratory care. This consisted of nasotracheal intubation, arterial cannulation, pulmonary artery catheterization, and establishment of mechanical ventilation. The algorithm further defines the subsequent management of these patients as far as need for continued mechanical ventilation, fluid and electrolyte balance, hemodynamic stability, and renal function.