Impact of primary blast lung injury during combat operations in Afghanistan

Aboudara, Matthew; Hicks, B; Cuadrado, Daniel G.; Mahoney, PF; Docekal, Jeremy

doi:10.1136/jramc-2015-000481

Cited by 3 publications

(3 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Introductionmentioning

confidence: 70%

“…A review of terrorist bombings worldwide found the incidence of PBLI in immediate fatalities to be as high as 47% 2 ; whilst in a review of military blast casualties that survived to emergency admission, PBLI was found in 11.2% of 648 blast casualties. In this series, 16.2% of mounted and 17.1% of dismounted injuries developed PBLI, which was significantly associated with increased mortality 3,4 .Laboratory investigations of PBLI have sought to recapitulate the injury under experimental conditions. Studies investigating the subsequent immune response have been reported most commonly in rats 5-10 , mice [11][12][13][14][15] and swine 16,17 .…”

mentioning

confidence: 98%

See 1 more Smart Citation

CD43Lo classical monocytes participate in the cellular immune response to isolated primary blast lung injury

Barnett-Vanes

Sharrock

Eftaxiopoulou

et al. 2016

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

BackgroundExplosive blast trauma occurs by four mechanisms: primary injuries are due to the isolated effect of the blast wave on the human body, secondary injuries are due to damage from fragments energised from the explosion, tertiary injuries result from acceleration of the body against an object or through the explosion energising hard materials in a solid form (not fragments) and encroaching upon the person, and quaternary injuries describe other physical insults, including burns and smoke inhalation 1 .Gas-containing organs such as the lungs are particularly susceptible to barotrauma, and 'Primary Blast Lung Injury' (PBLI) is a commonly reported injury amongst blast casualties. A review of terrorist bombings worldwide found the incidence of PBLI in immediate fatalities to be as high as 47% 2 ; whilst in a review of military blast casualties that survived to emergency admission, PBLI was found in 11.2% of 648 blast casualties. In this series, 16.2% of mounted and 17.1% of dismounted injuries developed PBLI, which was significantly associated with increased mortality 3,4 .Laboratory investigations of PBLI have sought to recapitulate the injury under experimental conditions. Studies investigating the subsequent immune response have been reported most commonly in rats 5-10 , mice [11][12][13][14][15] and swine 16,17 . These studies have offered overwhelming evidence of the neutrophil response to PBLI in animal models, with increases in circulating and broncho-alveolar lavage fluid (BALF) neutrophils, increases in Myeloperoxidase (MPO) activity in the lung, and neutrophil staining by histology [9][10][11][12]14,18,19 . However, the immune response to tissue damage differs depending on the type of organ injured and their local physiology; it remains unclear what specific contribution blast injuries to different parts of the body make to the inflammatory response that ensues. Whilst most clinically blast injured patients are polytraumatised, discerning these interacting immune responses experimentally is necessary for translational studies seeking to better understand, monitor or attenuate the immune response in blast trauma.Further, knowledge of the role played by other immune cells to PBLI is limited -no study has characterised the full repertoire of immune cells in PBLI; specifically, the involvement of monocytes in PBLI remains unclear. These cells are frequently recruited to sites of inflammation; in humans they are characterised by differential CD14 and CD16 expression 20 , in mice by CCR2, CX3CR1 and Ly6C 21,22 and in rats by CD43 alone or in conjunction with His48 23 . In rats, CD43 Hi and Lo monocytes are considered to be analogous to the Ly6C Lo (Non-classical) and Ly6C Hi (Classical) murine monocytes respectively. Classical Ly6C Hi monocytes are recruited to tissues in sterile 24 and infectious 25 models of inflammation. There, they can differentiate into inflammatory macrophages and dendritic cells, amplifying or resolving inflammation. In rats, circulating monocyte subsets are activated by inflammator...

show abstract

Section: Introductionmentioning

confidence: 70%

mentioning

confidence: 98%

CD43Lo classical monocytes participate in the cellular immune response to isolated primary blast lung injury

Barnett-Vanes

Sharrock

Eftaxiopoulou

et al. 2016

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

show abstract

“…e incidence of primary blast lung injury (PBLI) in immediate fatalities may be as high as 47% [11]. In a study on explosive injury victims who survived to emergency admission, PBLI was present in 11.2% of 648, 16.2% of mounted injuries, and 17.1% of dismounted injuries in the same sample developed for PBLI, which is significantly associated with increased mortality [12,13].…”

Section: Introductionmentioning

confidence: 99%

Effects of Explosion Shock Waves on Lung Injuries in Rabbits

Sun

Qian

Shu

et al. 2021

Shock and Vibration

View full text Add to dashboard Cite

The purpose of this study was to explore the damage effects and injury mechanism of free-field explosion shock waves on rabbit lungs. Six free-field explosion experiments, each with 500 g trinitrotoluene (TNT), were conducted as the shock wave overpressure acting on the rabbits was measured. The peak overpressure of the shock wave was 533, 390, 249, 102, and 69 kPa at the respective test points. Damage to the rabbit lungs caused by shock wave overpressure was investigated through observation, anatomical analysis, and hematoxylin-eosin (HE) staining processing. The shock wave overpressure of 69–102 kPa caused mild-to-moderate injury; the shock wave overpressure of 102–249 kPa caused moderate injury; the shock wave overpressure of 249–390 kPa resulted in moderate-to-severe injury; and the shock wave overpressure of 390–533 kPa caused severe injury to the rabbit. Mild, moderate, and severe injuries destroyed some, most, or all alveolar structures, correspondingly, as well as producing partial cell apoptosis. The overpressure damage mechanism primarily involves the collapse and rupture of pulmonary alveolus in the lung tissue. As a novel attempt, the investigation provided here may serve to improve the current shock wave injury mechanism.

show abstract

Management of combined massive burn and blast injury: A 20-year experience

Zheng

Zhu

et al. 2020

Burns

View full text Add to dashboard Cite

Impact of primary blast lung injury during combat operations in Afghanistan

Cited by 3 publications

References 2 publications

CD43Lo classical monocytes participate in the cellular immune response to isolated primary blast lung injury

CD43Lo classical monocytes participate in the cellular immune response to isolated primary blast lung injury

Effects of Explosion Shock Waves on Lung Injuries in Rabbits

Management of combined massive burn and blast injury: A 20-year experience

Contact Info

Product

Resources

About