Direct heat causes a burn injury to the mucosae of the upper airways in a similar manner to heat applied to the skin. The longer the duration, or the greater the intensity, of heat energy exposure, the greater is the depth of injury. Local inflammatory mediators are produced that cause mucosal oedema. However, this effect may be slow to fully manifest; maximal swelling with possible respiratory obstruction may not occur for up to 24 hours.
Rarely is an inhalational burn above the larynx of sufficient intensity to damage the lower respiratory tract.
In children with relatively narrow calibre airways, oedema and respiratory obstruction may be more likely. This is particularly true if there is an external burn on the neck causing a restrictive block to expansion.
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