Blast lung injury: clinical manifestations, treatment, and outcome

Blast lung injury (BLI) is a major cause of morbidity after terrorist bomb attacks (TBAs) and is seen with increasing frequency worldwide. Yet, many surgeons and intensivists have little experience treating BLI. Jerusalem sustained 31 TBAs since 1983, resulting in a local expertise in treating BLI....

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Bibliographic Details
Published in:The American journal of surgery 2005-12, Vol.190 (6), p.945-950
Main Authors: Avidan, Vered, Hersch, Moshe, Armon, Yaron, Spira, Ram, Aharoni, Dvora, Reissman, Petachia, Schecter, William P.
Format: Article
Language:English
Subjects:
Acute lung injury
Adolescent
Adult
Aged
Asthma
Barotrauma
Biological and medical sciences
Blast Injuries - complications
Blast Injuries - diagnostic imaging
Blast Injuries - therapy
Blast injury
Child
Child, Preschool
Consciousness
Eardrum
Emergency medical care
Explosions
Female
Follow-Up Studies
General aspects
Hospitals
Humans
Hypoxia
Hypoxia - etiology
Hypoxia - mortality
Hypoxia - therapy
Inhalers
Injuries
Intubation
Intubation, Intratracheal
Length of Stay
Lung Injury
Lungs
Male
Medical sciences
Middle Aged
Missing data
Mortality
Patients
Positive-Pressure Respiration - methods
Radiography, Thoracic
Respiratory Distress Syndrome, Adult - etiology
Respiratory Distress Syndrome, Adult - mortality
Respiratory Distress Syndrome, Adult - therapy
Retrospective Studies
Spinal cord
Survival Rate
Terrorism
Time Factors
Tomography, X-Ray Computed
Trauma Severity Indices
Treatment Outcome
Ventilation
Ventilators
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Summary:Blast lung injury (BLI) is a major cause of morbidity after terrorist bomb attacks (TBAs) and is seen with increasing frequency worldwide. Yet, many surgeons and intensivists have little experience treating BLI. Jerusalem sustained 31 TBAs since 1983, resulting in a local expertise in treating BLI. A retrospective study of clinical and radiologic characteristics, management, and outcome of victims of TBAs sustaining BLI who were admitted to ICU during December 1983 to February 2004. Long-term outcome was determined by a telephone interview. Twenty-nine patients met inclusion criteria. Hypoxia and pulmonary infiltrates in chest x-ray were sine qua non for the diagnosis. Seventy-six percent required mechanical ventilation, all within 2 hours of admission. One patient died. Seventy-six percent had no long-term sequelae. Most patients with significant BLI injury require mechanical ventilation. Late deterioration is rare. Death because of BLI in patients who survived the explosion is unusual. Timely diagnosis and correct treatment result in excellent outcome.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2005.08.022