US Air Force Academy, 2354 Fairchild Drive, USAF Academy, CO 80840, USA.
Neuroimage. 2011 Jan;54 Suppl 1:S55-61. doi: 10.1016/j.neuroimage.2010.05.025. Epub 2010 May 17.
Research in blast-induced lung injury resulted in exposure thresholds that are useful in understanding and protecting humans from such injury. Because traumatic brain injury (TBI) due to blast exposure has become a prominent medical and military problem, similar thresholds should be identified that can put available research results in context and guide future research toward protecting war fighters as well as diagnosis and treatment. At least three mechanical mechanisms by which the blast wave may result in brain injury have been proposed-a thoracic mechanism, head acceleration, and direct cranial transmission. These mechanisms need not be mutually exclusive. In this study, likely regions of interest for the first two mechanisms based on blast characteristics (positive pulse duration and peak effective overpressure) are developed using available data from blast experiments and related studies, including behind-armor blunt trauma and ballistic pressure wave studies. These related studies are appropriate to include because blast-like pressure waves are produced that result in neurological effects like those caused by blast. Results suggest that injury thresholds for each mechanism are dependent on blast conditions, and that under some conditions, more than one mechanism may contribute. There is a subset of blast conditions likely to result in TBI due to head acceleration and/or a thoracic mechanism without concomitant lung injury. These results can be used to guide experimental designs and compare additional data as they become available. Additional data are needed before actual probabilities or severity of TBI for a given exposure can be described.
爆炸伤肺的研究产生了一些暴露阈值，这些阈值有助于理解和保护人类免受此类伤害。由于爆炸引起的创伤性脑损伤（TBI）已成为一个突出的医学和军事问题，因此应该确定类似的阈值，以便将现有研究结果置于上下文中，并指导未来的研究，以保护作战人员以及进行诊断和治疗。已经提出了至少三种冲击波可能导致脑损伤的机械机制——胸部机制、头部加速度和直接颅骨传递。这些机制不必相互排斥。在这项研究中，根据爆炸特性（正脉冲持续时间和峰值有效超压），使用来自爆炸实验和相关研究的可用数据（包括装甲背面钝器伤和弹道压力波研究）开发了前两种机制的可能感兴趣区域。这些相关研究是合适的，因为产生了类似于爆炸引起的神经效应的类似爆炸的压力波。结果表明，每个机制的损伤阈值取决于爆炸条件，在某些条件下，可能有不止一种机制起作用。有一组爆炸条件可能会导致头部加速度和/或胸部机制引起的 TBI，而不会同时导致肺损伤。这些结果可用于指导实验设计，并在获得更多数据时进行比较。在给定暴露的 TBI 的实际概率或严重程度之前，还需要更多的数据。
