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长期爆炸导致肺部损伤的风险评估:一项荟萃分析

Pulmonary injury risk assessment for long-duration blasts: a meta-analysis.

作者信息

Rafaels Karin A, Bass Cameron R Dale, Panzer Matthew B, Salzar Robert S

机构信息

Department of Biomedical Engineering, Center for Applied Biomechanics, University of Virginia, Charlottesville, Virginia 22902, USA.

出版信息

J Trauma. 2010 Aug;69(2):368-74. doi: 10.1097/TA.0b013e3181e88122.

Abstract

BACKGROUND

Long-duration blasts are an increasing threat with the expanded use of thermobaric and other novel explosives. Other potential long-duration threats include large explosions from improvised explosive devices, weapons caches, and other explosives including nuclear explosives. However, there are very few long-duration pulmonary blast injury assessments, and use of short-duration exposure injury metrics is inappropriate as the injury mechanism for long-duration exposures is likely different from that of short-duration exposures.

METHODS

This study develops an injury model for long-duration (>10 milliseconds positive overpressure phase) blasts with sharp rising overpressures. For this study, data on more than 2,730 large animal experiments were collected from more than 55 experimental studies on blast. From this dataset, nearly 850 large animal experiments were selected with positive phase overpressure durations of 10 milliseconds or more. Various models were evaluated to determine the best fit of injury risk as a function of pressure and duration. A linear logistic regression was performed on the experimental data for threshold injury and lethality in terms of pressure and duration. The effects of mass, pressure, and duration scaling were all evaluated, and two goodness-of-fit indicators were used to assess the different models.

RESULTS AND CONCLUSIONS

New injury risk assessment curves were determined for both incident and reflected pressure conditions for reflecting surface and free-field exposures. Position dependent injury risk curves were also determined. The resulting curves are an improvement to existing assessments, because they use actual data to demonstrate theoretical assumptions on the injury risk.

摘要

背景

随着温压弹和其他新型炸药的使用范围不断扩大,长时间爆炸造成的威胁日益增加。其他潜在的长时间威胁包括简易爆炸装置、武器库及其他炸药(包括核炸药)引发的大爆炸。然而,针对长时间肺爆震伤的评估非常少,使用短时间暴露损伤指标并不合适,因为长时间暴露的损伤机制可能与短时间暴露不同。

方法

本研究建立了一种针对超压急剧上升的长时间(正超压阶段>10毫秒)爆炸的损伤模型。在本研究中,从55项以上的爆炸实验研究中收集了2730多个大型动物实验的数据。从该数据集中,选取了近850个正相超压持续时间为10毫秒或更长时间的大型动物实验。对各种模型进行评估,以确定损伤风险与压力和持续时间函数的最佳拟合。对实验数据进行线性逻辑回归,以确定压力和持续时间方面的阈损伤和致死率。评估了质量、压力和持续时间缩放的影响,并使用两个拟合优度指标来评估不同模型。

结果与结论

确定了反射面和自由场暴露在入射压力和反射压力条件下的新损伤风险评估曲线。还确定了位置相关的损伤风险曲线。所得曲线是对现有评估的改进,因为它们使用实际数据来证明关于损伤风险的理论假设。

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