Reactive Airways Dysfunction Syndromes Induced by Inhalation Injury / 소아알레르기및호흡기학회지

ABSTRACT

PURPOSE: Reactive airways dysfunction syndrome (RADS) is characterized by the appearance of asthma-like symptoms and an increase in nonspecific bronchial hyperresponsiveness in previously healthy individuals after a single large exposure to irritating gas, fume, or vapor, usually as a result of an accident. The purpose of this study is to evaluate the incidence of RADS and clinical characteristics after inhalation injury in children. METHODS: We analyzed nine male children with inhalation injuries from an elementary school fire accident. Clinical manifestations, PFTs including provocation test by methacholine and exercise, radiologic evaluations, skin test and serologic test for evidence of allergy were evaluated at 8 months after the inhalation injury. RESULTS: No documented preexisting respiratory illness was identified, nor did subjects relate past respiratory problems. All subjects suffered from the persistence of respiratory symptoms (cough on exertion, dyspnea on exertion or voice change in five subjects). All subjects showed normal chest X-rays, but a mosaic pattern was documented in the HRCT of three subjects. Basal FEV1 (%predicted) was decreased in one subject and FEF25-75% was decreased significantly in two subjects. Methacholine challenge test was positive in four subject and Exercise provocation tests showed significant decreases of FEV1 and FEF25-75% in three subjects. In four subjects, atopy was documented and but in all others, no evidence of atopy was identified. CONCLUSION: This study showed that RADS could develop after inhalation of irritants, and might persist. Inhalation injury patients should be closely monitored on respiratory symptoms and PFT.