Some Physiologic Observations in Smoke Inhalation

¹ Division of Pulmonary Diseases, Department of Internal Medicine, Mount Sinai Hospital, Miami Beach

Six persons were overcome by smoke inhalation when they were trapped within an elevator of a burning building. Evidence of bronchospasm as determined by spirometric examination was found in all six, but the only three who exhibited wheezing reported preexisting asthmatic conditions. An elevated carboxyhemoglobin was found in all. Three patients had metabolic acidosis but this finding did not correlate with the carboxyhemoglobin saturations. Two patients developed acute myocardial infarction; both had preexisting coronary artery disease. Our physiologic observations indicate that in addition to the routine use of oxygen, victims of smoke inhalation should be under careful surveillance, and may benefit from bronchodilators and corticosteroids. Arterial blood gas analysis should be done to determine the severity of hypoxemia. Metabolic acidosis, if present, should be treated with intravenous sodium bicarbonate.