title: Characteristics and mechanisms of cardiopulmonary injury caused by mine blasts in shoals: a randomized controlled study in a rabbit model.
abstract: BACKGROUND
  Because the characteristics of blast waves in water are different from those in air and because kinetic energy is liberated by a pressure wave at the water-air interface, thoracic injuries from mine blasts in shoals may be serious. The aim of the present study was to investigate the characteristics and mechanisms of cardiopulmonary injury caused by mine blasts in shoals.
  
  
  METHODS
  To study the characteristics of cardiopulmonary injury, 56 animals were divided randomly into three experimental groups (12 animals in the sham group, 22 animals in the land group and 22 animals in the shoal group). To examine the biomechanics of injury, 20 animals were divided randomly into the land group and the shoal group. In the experimental model, the water surface was at the level of the rabbit's xiphoid process, and paper electric detonators (600 mg RDX) were used to simulate mines. Electrocardiography and echocardiography were conducted, and arterial blood gases, serum levels of cardiac troponin I and creatine kinase-MB and other physiologic parameters were measured over a 12-hour period after detonation. Pressures in the thorax and abdomen and the acceleration of the thorax were measured.
  
  
  CONCLUSIONS
  The results indicate that severe cardiopulmonary injury and dysfunction occur following exposure to mine blasts in shoals. Therefore, the mechanisms of cardiopulmonary injury may result from shear waves that produce strain at the water-air interface. Another mechanism of injury includes the propagation of the shock wave from the planta to the thorax, which causes a much higher peak overpressure in the abdomen than in the thorax; as a result, the abdominal organs and diaphragm are thrust into the thorax, damaging the lungs and heart.
authors.affiliation: Department of Orthopedics, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Gengfen
authors.initials: G
authors.lastname: Han
authors.affiliation: Department of Orthopedics, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Ziming
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Ultrasound, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Weixiao
authors.initials: W
authors.lastname: Yang
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jianyi
authors.initials: J
authors.lastname: Kang
authors.affiliation: Department of Orthopedics, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Sen
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Aimin
authors.initials: A
authors.lastname: Wang
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Xinan
authors.initials: X
authors.lastname: Lai
mesh_terms: D000818:Animals; D001753:Blast Injuries / Q000503:physiopathology*; D004195:Disease Models, Animal; D005107:Explosions; D006335:Heart Injuries / Q000503:physiopathology*; D055370:Lung Injury / Q000503:physiopathology*; D011817:Rabbits; D013898:Thoracic Injuries / Q000503:physiopathology*