Int J Burn Trauma 2012;2(3):167-170

Original Article
Burning HOT: revisiting guidelines associated with home
oxygen therapy

Elizabeth J Litt, Rolf Ziesche, Wolfgang Happak, David Benjamin Lumenta

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Waehringer
Guertel 18-20, A-1090 Vienna, Austria; Department of Internal Medicine II, Clinical Division of Pulmonary
Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Division of Plastic,
Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29,
A-8036 Graz, Austria

Received September 7, 2012; Accepted November 3, 2012; Epub December 5, 2012; Published December 15,
2012

Abstract: Burn injuries secondary to home oxygen therapy (HOT) have become increasingly common in recent years,
yet several guidelines for HOT and chronic obstructive pulmonary disease (COPD) neglect to stress the dangers of
open flames. This retrospective review of burn injury admissions secondary to HOT to our burn centre from 2007 to
2012 aimed to establish the extent of this problem and to discuss the current literature and a selection of national
guidelines. Out of six patients (five female, one male) with a median age of 72 (range 58-79), four were related to
smoking, and two due to lighting candles. The mean total body surface area (TBSA) affected was 17% (range 2-60%).
Five patients sustained facial burns, two suffered from inhalation injury (33.3%), and five required surgery (83.3%).
Mean total length of stay was 20 days (range 8 to 33), and one patient died. Although mentioned in the majority,
some guidelines fail to address the issue of smoking in light of the associated risk for injury, which in turn might
have future implications in litigation related to iatrogenic injuries. Improved HOT guidelines will empower physicians
to discourage smoking, and fully consider the risks versus benefits of home oxygen before prescription. With a view
on impeding a rising trend of burns secondary to HOT, we suggest revision to national guidelines, where appropriate.
(IJBT1209001).

Keywords: Oxygen inhalation therapy, burns, smoking, pulmonary disease, chronic obstructive, guidelines, practice


Address correspondence to:
Dr. David B Lumenta
Division of Plastic, Aesthetic and Reconstructive Surgery
Department of Surgery, Medical University of Graz
Auenbruggerplatz 29, A-8036 Graz, Austria.
Tel: +43-316-385-14685; Fax: +43-316-385-14690
E-mail: david.lumenta@medunigraz.at
IJBT Copyright © 2011-present, All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711, USA