Prat Nicolas, Rongieras Frédéric, Voiglio Eric, Magnan Pascal, Destombe Casimir, Debord Eric, Barbillon Franck, Fusai Thierry, Sarron Jean-Claude
Surgical and Physiological Research Unit, French Army Institute of Biomedical Research (IRBA), Marseille, Department of Orthopaedic and Trauma Surgery, Université de Lyon, Lyon, France.
J Trauma. 2010 Oct;69(4):749-55. doi: 10.1097/TA.0b013e3181f2fe30.
Blunt thoracic trauma including behind armour blunt trauma or impact from a less lethal kinetic weapon (LLKW) projectile may cause injuries, including pulmonary contusions that can result in potentially lethal secondary complications. These lung injuries may be caused by intrathoracic pressure waves. The aim of this study was to observe dynamic changes in intrathoracic hydrostatic pressure during ballistic blunt thoracic trauma and to find correlations between these hydrostatic pressure parameters (especially the impulse parameter) and physical damages.
Thirty anesthetized pigs sustained a blunt thoracic trauma. In group 1 (n = 20), pigs were protected by a National Institute of Justice class III or IV bulletproof vest and shot with 7.62 NATO bullets. In group 2 (n = 10), pigs were shot by an LLKW. Intrathoracic pressure was recorded with an intraesophageal pressure sensor and three parameters were determined: intrathoracic maximum pressure, intrathoracic maximum pressure impulse (PI(max)), and the Pd.P/dt(max), derived from Viano's viscous criterion. Relative right lower lung lobe contusion volume was also measured.
Different thoracic loading conditions were obtained. PI(max) best correlated with relative pulmonary contusion volume (R² = 0.64 and p < 0.0001). This result was homogenous for all experiments and was not related to the type of chest impact (LLKW-induced trauma or behind armour blunt trauma).
The PI(max) is a good predictor of pulmonary contusion volume after ballistic blunt thoracic trauma. It is a useful criterion when the kinetic energy record or thoracic wall displacement data are unavailable, and the recording and calculation of this physical value are quite simple on animals.
钝性胸部创伤，包括防弹衣后钝性创伤或来自低致死性动能武器（LLKW）射弹的撞击，可能会导致损伤，包括肺挫伤，进而可能引发潜在致命的继发性并发症。这些肺部损伤可能由胸内压力波引起。本研究的目的是观察弹道钝性胸部创伤期间胸内静水压的动态变化，并找出这些静水压参数（尤其是冲量参数）与身体损伤之间的相关性。
30只麻醉猪遭受钝性胸部创伤。在第1组（n = 20）中，猪穿着美国国家司法研究所III级或IV级防弹背心，并被7.62北约子弹射击。在第2组（n = 10）中，猪被低致死性动能武器射击。用食管内压力传感器记录胸内压力，并确定三个参数：胸内最大压力、胸内最大压力冲量（PI(max)）以及根据维亚诺粘性标准得出的Pd.P/dt(max)。还测量了右下肺叶相对挫伤体积。
获得了不同的胸部负荷条件。PI(max)与相对肺挫伤体积的相关性最佳（R² = 0.64，p < 0.0001）。该结果在所有实验中均一致，且与胸部撞击类型（低致死性动能武器所致创伤或防弹衣后钝性创伤）无关。
PI(max)是弹道钝性胸部创伤后肺挫伤体积的良好预测指标。当动能记录或胸壁位移数据不可用时，它是一个有用的标准，并且在动物身上记录和计算这个物理值相当简单。
