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Background and Objectives:Respiratory failure remains one of the leading causes of death in burn patients with inhalationinjury. Obtaining and maintaining a secure airway are both essential and challenging. Although different airway managements areperformed in burn patients with inhalation injury, its exact indications and timing remain controversial. The purpose of this studyis to define the principle of airway management in burn patients with inhalation injury. Subjects and Method:A retrospectivestudy was performed on 177 burn patients with inhalation injury who were admitted to Hangang Sacred Heart Hospital at HallymUniversity Medical Center from July 2002 to June 2005. Results:Severty-seven patients underwent mask O2 supply for initialairway management. A total of 77 patients survived. One hundred patients underwent endotracheal intubation for initial airwaymanagement. Of these, 42 patients underwent tracheotomy after endotracheal intubation. A total of 42 patients reported abnormalchest X-ray findings. Of these, 10 patients survived and had significant improvement in PaO2/FiO2 ratios within 3 days followingtracheotomy. Conclusion:In most cases, laryngotracheal edema subsides within 72 hours, permitting short periods ofairway management. Deterioration of respiratory function permits prolonged intubation and ventilator support. Although tracheotomydoes not improve general condition, it offers some advantages in terms of pulmonary toilet, patient comfort and airwaysecurity. If patients show deterioration of respiratory function, tracheotomy should be performed earlier. (Korean J Otolaryngol2006;49:918-21)

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