Inhalation injury caused by cornstarch dust explosion in intubated patients—A single center experience

Background Around 10%–20% of burned patients have inhalation injuries, and the severity of these injuries is correlated with mortality. Fiberoptic bronchoscopy is an important tool for the early diagnosis of inhalation injury. This study investigated correlations between the severity of inhalation injury and outcomes of patients involved in a cornstarch dust explosion in northern Taiwan in 2015. Methods Patients with burns who were intubated after the explosion were enrolled. Their medical records were reviewed, and data including patient characteristics, percentage of total body surface area (%TBSA) burned, severity of the inhalation injury, mechanical ventilation settings, and outcomes were collected and analyzed. Results Twenty patients underwent fiberoptic bronchoscopy during the first 24 h to evaluate an inhalation injury. Their mean age was 22.4 ± 5.5 years and the mean %TBSA burned was 55.7 ± 19.4%. Fourteen patients had a grade 1 inhalation injury and six had a grade 2 injury. There was a higher %TBSA burned in the grade 1 group than in the grade 2 group, although the difference did not reach statistical significance (60.0 ± 20.3% versus 45.5 ± 13.5%, p = 0.129). Compared to the grade 2 group, the grade 1 group had a significantly higher white blood cell count (29.4 ± 9.3 versus 18.6 ± 4.6, p = 0.015) and frequency of facial burns (85.7% versus 33.3%, p = 0.037). The overall intensive care unit mortality rate was 10% (n = 2), with no significant intergroup difference (grade 1, 14.3% versus grade 2, 0%, p = 0.192). Conclusion Although the explosion resulted in a high rate of inhalation injuries in critically ill patients, there was no significant correlation between mortality and the severity of the inhalation injuries.