喷雾肝素
肝素可帮助预防急性肺损伤 (ALI) 和急性呼吸窘迫综合征 (ARDS) 患者的气道和肺泡内出现纤维蛋白沉积。[24]Enkhbaatar P, Herndon DN, Traber DL. Use of nebulized heparin in the treatment of smoke inhalation injury. J Burn Care Res. 2009;30:159-162.http://www.ncbi.nlm.nih.gov/pubmed/19180699?tool=bestpractice.com初步的临床和动物数据显示具有治疗希望,但尚未进行多中心试验。[31]Miller AC, Elamin EM, Suffredini AF. Inhaled anticoagulation regimens for the treatment of smoke inhalation-associated acute lung injury: a systematic review. Crit Care Med. 2014;42:413-419.http://www.ncbi.nlm.nih.gov/pubmed/24158173?tool=bestpractice.com[32]Elsharnouby NM, Eid HE, Abou Elezz NF, et al. Heparin/N-acetylcysteine: an adjuvant in the management of burn inhalation injury: a study of different doses. J Crit Care. 2014;29:182.e1-4.http://www.ncbi.nlm.nih.gov/pubmed/23932140?tool=bestpractice.com
生育酚
生育酚能清除活性氧和氮,已在动物模型证明有效。[25]Traber DL, Traber MG, Enkhbaatar P, et al. Tocopherol as treatment for lung injury associated with burn and smoke inhalation. J Burn Care Res. 2009;30:164-165.http://www.ncbi.nlm.nih.gov/pubmed/19060745?tool=bestpractice.com除了 α-生育酚之外的其他生育酚目前尚未批准用于人类。
皮质类固醇类
针对急性肺损伤和急性呼吸窘迫综合征进行的一些小型研究表明,吸入性皮质类固醇有潜在好处,但它们在吸入性损伤中的应用尚不明确。[26]Greenhalgh DG. Steroids in the treatment of smoke inhalation injury. J Burn Care Res. 2009;30:165-169.http://www.ncbi.nlm.nih.gov/pubmed/19060744?tool=bestpractice.com[33]de Lange DW, Meulenbelt J. Do corticosteroids have a role in preventing or reducing acute toxic lung injury caused by inhalation of chemical agents? Clin Toxicol (Phila). 2011;49:61-71.http://www.ncbi.nlm.nih.gov/pubmed/21370942?tool=bestpractice.com 尚无数据支持系统性皮质类固醇可降低吸入性损伤的炎症。[34]Bartley AC, Edgar DW, Wood FM. Pharmaco-management of inhalation injuries for burn survivors. Drug Des Devel Ther. 2009;2:9-16.http://www.ncbi.nlm.nih.gov/pubmed/19920889?tool=bestpractice.com
维生素 C
小型试验已证明大剂量维生素 C 能提高氧合作用,但作用机制未知,且缺乏大型试验的支持。[28]Wolf SE. Vitamin C and smoke inhalation injury. J Burn Care Res. 2009;30:184-186.http://www.ncbi.nlm.nih.gov/pubmed/19060764?tool=bestpractice.com
抗凝血酶-III
现已注意到烧伤患者会出现抗凝血酶缺乏,这是一种有抗炎作用的丝氨酸蛋白酶抑制剂。现正在对抗凝血酶-III 进行临床研究;但大型临床试验尚未证明其有效性。[29]Latenser, BA. Use of antithrombin III in inhalation injury. J Burn Care Res. 2009;30:186-188.http://www.ncbi.nlm.nih.gov/pubmed/19060754?tool=bestpractice.com
抗炎药
采用药剂(例如非甾体抗炎药物和白三烯抑制剂)来抑制环氧合酶 (COX) 和脂氧合酶的炎症通路,在动物模型已显示有希望,但尚缺乏人体试验。[34]Bartley AC, Edgar DW, Wood FM. Pharmaco-management of inhalation injuries for burn survivors. Drug Des Devel Ther. 2009;2:9-16.http://www.ncbi.nlm.nih.gov/pubmed/19920889?tool=bestpractice.com