Virchows Archiv A

, Volume 379, Issue 4, pp 299–311 | Cite as

Heat injuries to the respiratory system

  • Bernd Brinkmann
  • Klaus Püschel
Original Investigations


A steam-tube of the main boiler exploded on a ship lying in the harbour of Hamburg. The steam temperature was 283‡ C. Cutaneous and severe inhalational scalding occured in the 27 fatalities, the men dying after different intervals.

This paper deals with the pathological findings in the respiratory passages and the lung, describing the topographical extent of direct thermal injury and the temporal course of tissue reactions.

In cases of instantaneous death coagulation necrosis of the tracheal and bronchial wall was found to extend to alveolar ducts in central parts of the lung. The lung parenchyma showed marked congestion, alveolar edema and desquamation of alveolar epithelial cells. Death occured due to acute pulmonary dysfunction and shock.

Lethal complications following the period of primary shock consisted of fulminant confluent bronchopneumonia, the hyaline membrane syndrome or the onset of desquamative interstitial pneumonia. These changes rendered it difficult to evaluate the effects of the heavy cutaneous scalding on the pathological course of inhalational injuries in those surviving for longer periods.

Key words

Explosion Burns Pathohistology Air passages Lung 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Achauer, B.M., Allyn, P.A., Furnas, D.W., Bartlett, R.H.: Pulmonary complications of burns. Ann. Surg. 177, 311–319 (1973)Google Scholar
  2. Allgöwer, M., Siegrist, J.: Verbrennungen. Berlin-Göttingen-Heidelberg: Springer 1957Google Scholar
  3. Aviado, D.M., Schmidt, C.F.: Respiratory burns with special reference to pulmonary edema and congestion. Circulation 6, 666–680 (1952)Google Scholar
  4. Di Vincenti, F.C., Pruitt, B.A., Reckler, J.M.: Inhalation injuries. J. Trauma 11, 109–116 (1971)Google Scholar
  5. Femenic, B.: Changes in the tracheal respiratory mucosa of rats following experimentally induced burns of the skin. Pract. oto-rhino-laryng. 31, 7–10 (1969)Google Scholar
  6. Förster, A.: Experimentelle Untersuchungen über VerÄnderungen an den Atmungsorganen bei plötzlicher Einwirkung hoher Temperaturen. Dtsch. Z. ges. gerichtl. Med. 20, 445–460 (1933)Google Scholar
  7. Foley, F.D., Moncrief, J.A., Mason, A.D.: Pathology of the lung in fatally burned patients. Ann. Surg. 167, 251–264 (1968)Google Scholar
  8. Goldbach, H.-J.: Gibt es vitale Reaktionen der Lunge nach Hei\lufteinatmung? Dtsch. Z. ges. gerichtl. Med. 45, 394–400 (1956)Google Scholar
  9. Hagedorn, M., Pfrieme, B., Mittermayer, Ch., Sandritter, W.: Intravitale und pathologisch-anatomische Beobachtungen beim Verbrennungsschock des Kaninchens. Beitr. Path. 115, 398–409 (1975)Google Scholar
  10. Hardaway, R.M.: Syndromes of disseminated intravascular coagulation. Springfield: Charles C. Thomas 1966Google Scholar
  11. Lasch, H.G., Róka, L., Heene, D.: The defibrination syndrome. Thrombos. Diathes. haemorrh. (Stuttg.) Suppl. 20, 97–105 (1966)Google Scholar
  12. Mallory, T.B., Brickley, W.J.: Management of the Cocoanut Grove Burns at the Massachusetts General Hospital. Pathology: with special reference to the pulmonary lesions. Ann. Surg. 117, 865–884 (1943)Google Scholar
  13. Mittermayer, C., Vogel, W., Burchadi, H., Birzle, H., Wiemers, K., Sandritter, W.: Pulmonale Mikrothrombosierung als Ursache der respiratorischen Insuffizienz bei Verbrauchskoagulopathie (Schock-Lunge). Dtsch. med. Wschr. 95, 1999–2002 (1970)Google Scholar
  14. Moritz, A.R., Henriques, F.C., Mc Lean, R.: The effects of inhealed heat on the air passages and lungs. Am. J. Path. 21, 311–331 (1945)Google Scholar
  15. Remmele, W., Goebel, U.: Zur pathologischen Anatomie des Kreislaufschocks beim Menschen. V. Pathomorphologie der Schocklunge. Klin. Wschr. 51, 25–36 (1973)Google Scholar
  16. Sandritter, W., Lasch, H.: Pathologic aspects of shock. Meth. Achievm. exp. Path. 3, 86–121 (1967)Google Scholar
  17. Sochor, F.M., Mallory, G.K.: Lung lesions in patients dying of burns. Arch. Pathol. 75, 303–308 (1963)Google Scholar
  18. Wolf, H., Neuhof, H.: Die sogenannte Schocklunge bei akuter Verbrühung. Med. Welt 26, 1775–1776 (1975)Google Scholar

Copyright information

© Springer-Verlag 1978

Authors and Affiliations

  • Bernd Brinkmann
    • 1
  • Klaus Püschel
    • 1
  1. 1.Institut für Rechtsmedizin der UniversitÄt HamburgHamburg 54Federal Republic of Germany

Personalised recommendations