Melzer E, Hersch M, Fischer D, Hershko C
Chest. 1986 May;89(5):690-3. doi: 10.1378/chest.89.5.690.
Forty six people were injured by a large explosive charge detonated in a Jerusalem bus. Four were killed instantaneously and 22 needed hospital care. We describe our experience in five patients with blast lung injury (BLI), all of whom survived in spite of severe respiratory failure requiring mechanical ventilation. Disseminated intravascular clotting (DIC) developed in three of the five patients and significant hypopotassemia ranging from 2.2 to 2.9 mEq/L in four. These two complications have not been previously described in association with BLI. Both DIC and hypopotassemia responded to replacement therapy. Vigorous treatment of respiratory failure, early recognition, and prompt correction of hemostatic and electrolyte abnormalities may have contributed to the avoidance of fatalities among the five patients with severe blast injury.
在耶路撒冷一辆公交车上引爆的一枚大型炸药致使46人受伤。4人当场死亡，22人需要住院治疗。我们描述了5例肺爆震伤（BLI）患者的治疗经历，尽管他们出现了需要机械通气的严重呼吸衰竭，但均存活下来。5例患者中有3例发生了弥散性血管内凝血（DIC），4例出现了2.2至2.9 mEq/L的显著低钾血症。此前尚未有这两种并发症与肺爆震伤相关的报道。DIC和低钾血症均对替代疗法有反应。积极治疗呼吸衰竭、早期识别并迅速纠正止血和电解质异常可能有助于避免5例严重爆震伤患者死亡。
