Primary Blast Lung Injury

Abstract

In explosive accidents (military conflicts, terror assaults, and production and living associated explosions), the lungs are the most easily injured organs owing to the exposure of blast wave. The primary pulmonary blast injury (PBLI) constitutes the key aspect in the diagnosis and therapy of explosive blast injury. Presently, some new findings in the epidemiology, injury mechanism, diagnosis, and therapeutics have been given. Especially, the categories, patterns, equivalent weight, physico-chemical properties of explosive substances and more complicated spatial distribution of explosive sites, the state of PBLI, measures of its diagnosis and therapy, and prognostic outcome showed the characters of complexity and nonlinearity. Hence, the overall plan of this chapter firstly reviews the definition and connotation, epidemiology, and pathological changes of PBI. The injury mechanism and clinical outcome of PBLI were then elucidated from the biological mechanical points as well as neuroendocrine immune network. The common clinical manifestation, diagnosis, and therapeutic criteria of PBI were further introduced regarding the precision diagnosis and individualizing treatment. Finally, based on the idea that any efficient prevention is superior to excellent remedy, the preventive measures of PBLI were extensively discussed. As described elsewhere in this volume, based on the 4P (preventive, predictive, personalized and participatory) medicine models of burn and trauma, it is of great necessity to discriminate the regularity of happening and transformation of PBI from the view of translational medicine and investigate the probability of precision treatment of PBLI given its previous theoretical results. It may propel the transformation of patterns of its diagnosis and therapy from routine experienced qualitative to personalized quantitative treatment. The aim of the chapter tries to supply a new paradigm for the understanding of PBI.