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Damage to the pulmonary parenchyma from smoke represents a second cause of inhalation injury. To date, the treatment of lung injury due to smoke has been largely supportive in nature. Patients are intubated, placed on mechanical ventilation, and maintained on support until pulmonary status improves, permanent airway access obtained, or the patient dies. Given that the insult associated with inhalation injury causes direct pulmonary damage and that the lungs have the ability of absorb drugs, the use of inhaled therapies for inhalation injury is appealing. The goal of this chapter is to describe the potential role of inhalation therapies in the treatment of smoke inhalation injury.