title: Blast injuries to the lung: epidemiology and management.
abstract: Lung injury is frequently a component of the polytrauma sustained by military personnel surviving blast on the battlefield. This article describes a case series of the military casualties admitted to University Hospital Birmingham's critical care services (role 4 facility), during the period 1 July 2008 to 15 January 2010. Of the 135 casualties admitted, 107 (79.2%) were injured by explosive devices. Plain chest films taken soon after arrival in the role 4 facility were reviewed in 96 of the 107 patients. In 55 (57.3%) films a tracheal tube was present. One or more radiological abnormalities was present in 66 (68.75%) of the films. Five patients met the consensus criteria for the definition of adult respiratory distress syndrome (ARDS). The majority of casualties with blast-related lung injury were successfully managed with conventional ventilatory support employing a lung protective strategy; only a small minority received non-conventional support at any time in the form of high-frequency oscillatory ventilation. Of those casualties who survived to be received by the role 4 facility, none subsequently died as a consequence of lung injury.
authors.affiliation: Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: Iain M J
authors.initials: IM
authors.lastname: Mackenzie
authors.forename: Bill
authors.initials: B
authors.lastname: Tunnicliffe
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000266:history; D049674:History, 21st Century; D006801:Humans; D008887:Military Medicine / Q000379:methods* / Q000706:statistics & numerical data; D008889:Military Personnel; D011859:Radiography; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000628:therapy*; D006113:United Kingdom / Q000453:epidemiology; D014857:Warfare