| disease | Pneumonia |
Pneumonia is a common septic complication after burns, related to certain pathophysiological changes and immune dysfunction post-burn. It typically occurs within two weeks, is iatrogenic in nature, and requires attention to prevention and treatment.
bubble_chart Pathogen
1. Weakening of pulmonary defense function after burns: In the early stages of severe burn patients, consciousness is in a suppressed state, and the repeated use of sedatives and surgical anesthesia inhibits the cough reflex. Post-burn hyperventilation, endotracheal intubation, and tracheostomy injure the mucous membrane ciliary system. The clearance of bacteria by pulmonary macrophages is also suppressed after burns. In patients with head and face burns or inhalation injuries, early local swelling, increased secretions, and incomplete epiglottal closure make it easier for bacteria to be inhaled into the lungs. These factors collectively make the lungs a susceptible organ.
2. Aspiration pneumonia: Post-burn gastrointestinal dysfunction, gastric retention, and impaired consciousness with dulled reflexes increase the risk of aspiration pneumonia.
3. Inhalation injury: Inhalation injury impairs the airway's ability to clear bacteria, and the necrotic airway membrane serves as an ideal medium for bacterial growth.
4. Hematogenous disseminated pneumonia: This often occurs secondary to sepsis or other purulent foci, such as abscesses or suppurative thrombophlebitis.
Coarse breath sounds or dry/wet rales can be heard in the lungs, and there may be high fever. Diagnosis is mainly confirmed by chest X-ray.
bubble_chart Treatment Measures
1. Strengthen respiratory tract management: promptly remove respiratory secretions and dampness transformation in the respiratory tract. Pay attention to the care of the tracheotomy site for patients who have undergone tracheotomy.2. Actively treat the primary lesion: wound infections, suppurative thrombophlebitis, and soft tissue abscesses are common primary lesions of hematogenous pneumonia. While treating pneumonia, the primary lesions must be actively addressed.
3. Choose appropriate antibiotics: use sputum culture as the basis for selecting antibiotics. Pneumonia complicating burns is a type of nosocomial infection, with most pathogens being Pseudomonas aeruginosa, Klebsiella pneumoniae, and drug-resistant Staphylococcus aureus, which can serve as a reference when selecting antibiotics.
