Abstract
The ventilator management of severely injured blast victims is complex and must address the high incidence of polytrauma as well as the specific challenges of blast lung injury (BLI). While lessons can be extracted from the research on acute respiratory distress syndrome (ARDS), nuanced management changes are required when managing intensive care patients beyond the initial stabilization period.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Mayorga MA. The pathology of primary blast overpressure injury. Toxicology. 1997;121:17–28.
Champion HR, Holcomb JB, Young LA. Injuries from explosions: physics, biophysics, pathology and required research focus. J Trauma. 2009;66:1468–77.
Ritenour AE, Blackbourne LH, Kelly JF, McLaughlin DF, Pearse LA, Holcomb JB, et al. Incidence of primary blast injury in US military overseas contingency operations: a retrospective study. Ann Surg. 2010;251:1140–4.
Mellor SG, Cooper GJ. Analysis of 828 servicemen killed or injured by explosion in Northern Ireland 1970–1984: the hostile action casualty system. Br J Surg. 1989;76:1006–10.
Leibovici D, Gofrit ON, Stein M, Shapira SC, Noga Y, Heruti RJ, et al. Blast injuries: bus versus open-air bombings. A comparative study of injuries in survivors of open-air versus confined-space explosions. J Trauma. 1996;41:1030–5.
Weightman JM, Gladish SL. Explosions and blast injuries. Ann Emerg Med. 2001;37:664–78.
Mackenzie I, Tunnicliffe CJ, Mahoney P, Kirkman E. What the intensive care doctor needs to know about blast-related lung injury. JICS. 2013;14(4):303–12.
Tsokos M, Paulsen F, Petri S, Burkhard M, Puschel K, Turk E. Histologic, immunohistochemical, and ultrastructural findings in human blast lung injury. Am J Respir Crit Care Med. 2003;168:549–55.
Pizov R, Oppenheim-Eden A, Matot I, Weiss YG, Eidelman LA, Rivkind AI, et al. Blast lung injury from and explosion on a civilian bus. Chest. 1999;115:165–72.
Soldati G, Testa A, Silva FR, Carbone L, Portale G, Silveri NG. Chest ultrasonography in lung contusion. Chest. 2006;130(2):533–8.
Helmy S, Beshay B, Abdel Hady M, Mansour A. Role of chest ultrasonography in the diagnosis of lung contusion. Egypt J Chest Dis Tuberculosis. 2015;64:469–75.
Mackenzie IM, Tunnicliffe B. Blast injuries to the lung: epidemiology and management. Phil Trans R Soc B. 2011;366:295–9.
The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:301–8.
Edens JW, Chung KK, Pamplin JC, Allan PF, Jones JA, King BT, et al. Predictors of early acute lung injury at a combat support hospital: a prospective observational study. J Trauma. 2010;69 Suppl 1:S81–6.
Kirkman E, Watts S, Cooper G. Blast injury research models. Philos Trans R Soc Lond Ser B Biol Sci. 2011;366:144–59.
Papazian L, Forel J-M, Gacouin A, Penot-Ragon C, Perrin G, Loundou A, et al. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med. 2010;363:1107–16.
Guerin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368:2159–68.
Bou Zein Eddine S, Boyle KA, Dodgion CM, Davis CS, Webb TP, Juern JS, et al. Observing pneumothoraces: the 35-millimeter rule is safe for both blunt and penetrating chest trauma. J Trauma Acute Care Surg. 2019;86(4):557–64.
Mikita JA, Powell DF. Ventilation for tracheal disruption and bronchopleural fistula. In: Bukenmaier III C, Mahoney PF, editors. Combat anesthesia: the first 24 hours, vol. c2015. San Antonio: Borden Institute. p. 315–9.
Rudder N, Marcos B. Independent lung ventilation in severe traumatic unilateral lung injury with refractory hypoxemia. Crit Care Med. 2018;46(1 suppl):S779.
Heslet I, Nelsen JD, Levi M, Sengeloev H, Johansson P. Successful pulmonary administration of activated recombinant factor VII in Diffuse Alveolar Hemorrhage (DAH). Crit Care. 2006;10:R177.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Powell, D.F. (2020). Ventilator Strategies. In: Callaway, D., Burstein, J. (eds) Operational and Medical Management of Explosive and Blast Incidents. Springer, Cham. https://doi.org/10.1007/978-3-030-40655-4_39
Download citation
DOI: https://doi.org/10.1007/978-3-030-40655-4_39
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-40654-7
Online ISBN: 978-3-030-40655-4
eBook Packages: MedicineMedicine (R0)