Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, ICT Centre, Birmingham B15 2SQ, UK.
Department of Anaesthesia, Glenfield Hospital, Groby Road, Leicester, LE3 9QP UK.
Mil Med. 2020 Jun 8;185(5-6):e568-e572. doi: 10.1093/milmed/usz453.
Primary blast lung injury occurs when an explosive shock wave passes through the thorax and transits through tissues of varying densities. It requires close proximity to an explosion and presents quick with respiratory distress in survivors.
The Joint Theatre Trauma Registry and the Defence Statistics (Health) Database were interrogated for casualties injured as a result of an explosion during the conflict in Afghanistan. The case notes and imaging of casualties meeting the criteria for diagnosis were reviewed. Demographic and clinical data on casualties with primary blast lung injury were analyzed.
848 blast-exposed casualties survived to discharge from intensive care, and 238 blast-exposed casualties were killed in action. Following exclusions, 111 case notes and all postmortem reports were reviewed in detail. About, 25 casualties had isolated primary blast lung injury (2.9% of casualties surviving to discharge from intensive care) and 31 nonsurvivors (13% of nonsurvivors) had the disease documented at postmortem. Severe cases of primary blast lung injury required an estimated average of 4.5 days of conventional mechanical ventilation.
8.1% of blast exposed casualties suffered primary blast lung injury. It was a less severe disease than other nontraumatic forms of acute lung injury and did not cause deaths once a casualty had reached a combat support hospital. It was well managed with a relatively brief period of conventional mechanical ventilation.
原发性爆震性肺损伤发生在爆炸冲击波穿过胸部并穿过密度不同的组织时。它需要靠近爆炸源，并在幸存者中迅速出现呼吸窘迫。
联合战区创伤登记处和国防统计（健康）数据库被询问了在阿富汗冲突中因爆炸而受伤的人员。审查了符合诊断标准的伤员的病历记录和影像学资料。分析了原发性爆震性肺损伤伤员的人口统计学和临床数据。
848 名爆震暴露伤员从重症监护中存活并出院，238 名爆震暴露伤员在行动中死亡。排除后，详细审查了 111 份病历记录和所有尸检报告。约有 25 名伤员患有孤立性原发性爆震性肺损伤（从重症监护中存活并出院的伤员的 2.9%），31 名非幸存者（非幸存者的 13%）在尸检时记录了该病。严重的原发性爆震性肺损伤需要大约 4.5 天的常规机械通气。
8.1%的爆震暴露伤员患有原发性爆震性肺损伤。与其他非创伤性急性肺损伤形式相比，该病的严重程度较轻，一旦伤员到达战斗支援医院，就不会导致死亡。通过相对较短的常规机械通气治疗，可以很好地控制该病。
