Potential Inhalation Injury Treatments in the 2020's: How Quickly Will Science Progress and What Can We Expect?
An inhalation injury is a broad term used to describe damage to the respiratory system by a wide range of chemicals, including smoke, fumes, gases, and vapors. Smoke injury is the most common inhalation injury in the United States, and fires are tragically frequent, with more than 2,500 deaths and 11,500 fire injuries every year. One-third of burn victims will also have inhalation injuries, and they can be challenging to treat. Luckily, the science for inhalation injuries is always progressing. In this post, we’ll discuss some upcoming treatments, and when we might see them used to treat victims.
- Beta-agonists
On the day an inhalation injury occurs, the patient may be able to breathe with no difficulty. But as the damage progresses, the airway can become swollen, interfere with normal breathing, and even prevent intubation. Beta-agonists are medications that relax and widen the airway, resulting in more natural breathing. We call these medications beta-agonists because they activate the beta-2 receptor in the muscles surrounding the airway. They are also known as bronchodilators. Examples include albuterol and metaproterenol, often used to treat asthma and chronic obstructive pulmonary disease (COPD). Practitioners are currently using beta-agonists to treat some inhalation injuries.
- Pulmonary Blood Flow Modifiers
During normal functioning of the heart and lungs, the lungs receive blood from the right ventricle of the heart, which undergoes gas exchange in the lungs to provide oxygen to the body. This blood transfer is the pulmonary blood flow, and an inhalation injury can disrupt this. Medications such as inhaled nitrous oxide can modify the pulmonary blood flow, which can decrease pulmonary hypertension and decrease the need for ventilation or shunting after an inhalation injury.
- Anticoagulants
An anticoagulant like Heparin prevents blood from clotting. These medications can help prevent the airway from developing “fibrin casts,” which restrict and block the airway after an inhalation injury. While some studies have shown no improvement for inhalation injury patients, a systematic review of the research shows, “improved survival and decreased morbidity in preclinical and clinical studies.”
- Anti-inflammatories
Anti-inflammatory medications do just that – prevent inflammation. After an inhalation injury, parts of the respiratory system, including the airway, can swell. Using anti-inflammatories after such an injury can reduce swelling to the airway and other parts of the body, making breathing easier.Medical practitioners are now using many of these treatments for some inhalation injuries, but more research is needed before they become standard treatments. Over the next few years, we should see more promising research and treatments.
