Nebulized Heparin and N-Acetylcysteine do Not Improve Outcomes of Intubated Burn Patients With Grade II or III Inhalation Injuries

Inhalation injuries heighten the morbidity and mortality associated with burn injury. Nebulized heparin and N-acetylcysteine have been proposed as adjunctive treatments for severe inhalation injury. In this study, a total of 100 inhalation injuries were identified over a 4-year period, with 40 patients suffering grade II-III inhalation injuries confirmed via fiberoptic bronchoscopy. 47.5% of patients received the inhalation protocol of nebulized heparin, N-acetylcysteine, and albuterol. Patient demographics and inhalation injury grade were similar between the groups (2 vs 2, <i>P</i> = .20). The utilization of the inhalation protocol did not shorten the number of ventilator days (5 vs 6, <i>P</i> = .76) or show survival benefit (57.9 vs 52.4%, <i>P</i> = .73). An inhalational protocol did not improve outcomes in burn patients suffering abbreviated injury score (AIS) grade II-III inhalation injuries at our institution. Moving forward, large, multicenter, randomized control trials are needed to determine the true efficacy of nebulized heparin and N-acetylcysteine for AIS grade II-III injuries.