Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China.
Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin 300072, China.
Biomolecules. 2023 Feb 10;13(2):351. doi: 10.3390/biom13020351.
Primary blast lung injury (PBLI), caused by exposure to high-intensity pressure waves from explosions in war, terrorist attacks, industrial production, and life explosions, is associated with pulmonary parenchymal tissue injury and severe ventilation insufficiency. PBLI patients, characterized by diffused intra-alveolar destruction, including hemorrhage and inflammation, might deteriorate into acute respiratory distress syndrome (ARDS) with high mortality. However, due to the absence of guidelines about PBLI, emergency doctors and rescue teams treating PBLI patients rely on experience. The goal of this review is to summarize the mechanisms of PBLI and their cross-linkages, exploring potential diagnostic and therapeutic targets of PBLI. We summarize the pathophysiological performance and pharmacotherapy principles of PBLI. In particular, we emphasize the crosstalk between hemorrhage and inflammation, as well as coagulation, and we propose early control of hemorrhage as the main treatment of PBLI. We also summarize several available therapy methods, including some novel internal hemostatic nanoparticles to prevent the vicious circle of inflammation and coagulation disorders. We hope that this review can provide information about the mechanisms, diagnosis, and treatment of PBLI for all interested investigators.
原发性爆震性肺损伤（PBLI）是由于战争、恐怖袭击、工业生产和生活爆炸中高强度压力波的暴露而引起的，与肺实质组织损伤和严重通气不足有关。PBLI 患者表现为弥漫性肺泡内破坏，包括出血和炎症，可能恶化为急性呼吸窘迫综合征（ARDS），死亡率较高。然而，由于缺乏关于 PBLI 的指南，治疗 PBLI 患者的急诊医生和救援队伍只能依靠经验。本综述的目的是总结 PBLI 的机制及其相互联系，探索 PBLI 的潜在诊断和治疗靶点。我们总结了 PBLI 的病理生理表现和药物治疗原则。特别是，我们强调了出血和炎症之间以及凝血之间的相互作用，并提出早期控制出血是治疗 PBLI 的主要方法。我们还总结了几种可用的治疗方法，包括一些新型的内用止血纳米颗粒，以防止炎症和凝血紊乱的恶性循环。我们希望本综述能为所有感兴趣的研究者提供有关 PBLI 的机制、诊断和治疗的信息。
