Blast injuries

Wolf, Stephen J.; Bebarta, Vikhyat S.; Bonnett, Carl J.; Pons, Peter T.; Cantrill, Stephen V.

doi:10.1016/s0140-6736(09)60257-9

Cited by 343 publications

(329 citation statements)

References 111 publications

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“…We recommend a broader documentation of the type of injury as one of four categories: closed, penetrating, blast, and crush. This reflects the changing epidemiology and increased recognition of blast injuries of the brain as a specific entity (Wolf et al, 2009;Ling et al, 2009). Crush injuries result from a slow mechanical force applied to the skull, and are therefore different from acceleration/ deceleration or impact traumas.…”

Section: Maas Et Almentioning

confidence: 99%

Standardizing Data Collection in Traumatic Brain Injury

Maas

Harrison-Felix

Menon

et al. 2011

Journal of Neurotrauma

144

137

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Collaboration among investigators, centers, countries, and disciplines is essential to advancing the care for traumatic brain injury (TBI). It is thus important that we ''speak the same language.'' Great variability, however, exists in data collection and coding of variables in TBI studies, confounding comparisons between and analysis across different studies. Randomized controlled trials can never address the many uncertainties concerning treatment approaches in TBI. Pooling data from different clinical studies and high-quality observational studies combined with comparative effectiveness research may provide excellent alternatives in a cost-efficient way. Standardization of data collection and coding is essential to this end. Common data elements (CDEs) are presented for demographics and clinical variables applicable across the broad spectrum of TBI. Most recommendations represent a consensus derived from clinical practice. Some recommendations concern novel approaches, for example assessment of the intensity of therapy in severely injured patients. Up to three levels of detail for coding data elements were developed: basic, intermediate, and advanced, with the greatest level of detail attained in the advanced version. More detailed codings can be collapsed into the basic version. Templates were produced to summarize coding formats, explanation of choices, and recommendations for procedures. Endorsement of the recommendations has been obtained from many authoritative organizations. The development of CDEs for TBI should be viewed as a continuing process; as more experience is gained, refinement and amendments will be required. This proposed process of standardization will facilitate comparative effectiveness research and encourage high-quality meta-analysis of individual patient data.

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Section: Maas Et Almentioning

confidence: 99%

Standardizing Data Collection in Traumatic Brain Injury

Maas

Harrison-Felix

Menon

et al. 2011

Journal of Neurotrauma

144

137

View full text Add to dashboard Cite

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“…The lungs showed the most severe damage after the blast injury [1,27,28]. In the burn-blast combined injury group, the lungs were also severely damaged.…”

Section: Discussionmentioning

confidence: 96%

Development of an Animal Model for Burn-Blast Combined Injury and Cardiopulmonary System Changes in the Early Shock Stage

Chai

et al. 2014

Indian J Surg

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The purposes of this study were to establish an animal model for burn-blast combined injury research and elaborate cardiopulmonary system changes in the early shock stage. In this study, royal demolition explosive or RDX (hexagon, ring trimethylene nitramine) was used as an explosive source, and the injury conditions of the canine test subjects at various distances to the explosion (30, 50, and 70 cm) were observed by gross anatomy and pathology to determine a larger animal model of moderate blast injury. The canines were then subjected to a 35 % total body surface area (TBSA) full-thickness flame injury using napalm, which completed the development of a burn-blast combined injury model. Based on this model, the hemodynamic changes and arterial blood gas analysis after the burnblast combined injury were measured to identify the cardiopulmonary system characteristics. In this research, RDX explosion and flame injury were used to develop a severe burn-blast injury animal model that was stable, close to reality, and easily controllable. The hemodynamic and arterial blood gas changes in the canine subjects after burn-blast injury changed distinctly from the burn and blast injuries. Blood pressure and cardiac output fluctuated, and the preload was significantly reduced, whereas the afterload significantly increased. Meanwhile, the oxygen saturation (SO 2 ) decreased markedly with carbon dioxide partial pressure (PCO 2 ), and lactic acid (Lac) rose, and oxygen partial pressure (PO 2 ) reduced. These changes suggested that immediate clinical treatment is important during burn-blast injury both to stabilize cardiac function and supply blood volume and to reduce the vascular permeability, thereby preventing acute pneumonedema or other complications.

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“…Spallation is a process in which fragments of material are ejected from a body due to impact or stress. In the organs this occurs in such a way that dense tissues release debris in less dense media [10]. Implosion damage is due to the rapid compression and expansion of gases within the tissues: when these gases re-expand they suddenly transfer a large amount of energy to the surrounding structures [9].…”

Section: Introductionmentioning

confidence: 99%

“…These traumatic injuries are characterized by multiple fractures [3] and chronic pain, often leading to amputation. Specific complications can develop in traumatized limbs in these war wounds including heterotopic ossification (HO; aberrant bone formation outside the skeletal tissue), and the presentation of recurrent osteomyelitis (bone infection) [10,11]. This evidence suggests a strong correlation between the pathologies and the blast event that caused them.…”

Section: Introductionmentioning

confidence: 99%

Prospects for studying how high-intensity compression waves cause damage in human blast injuries

Brown¹,

Bo²,

Masouros³

et al. 2012

AIP Conference Proceedings

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Abstract. Since World War I, explosions have accounted for over 70% of all injuries in conflict. With the development of improved personnel protection of the torso, improved medical care and faster aeromedical evacuation, casualties are surviving with more severe injuries to the extremities. Understanding the processes involved in the transfer of blast-induced shock waves through biological tissues is essential for supporting efforts aimed at mitigating and treating blast injury. Given the inherent heterogeneities in the human body, we argue that studying these processes demands a highly integrated approach requiring expertise in shock physics, biomechanics and fundamental biological processes. This multidisciplinary systems approach enables one to develop the experimental framework for investigating the material properties of human tissues that are subjected to high compression waves in blast conditions and the fundamental cellular processes altered by this type of stimuli. Ultimately, we hope to use the information gained from these studies in translational research aimed at developing improved protection for those at risk and improved clinical outcomes for those who have been injured from a blast wave.

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Blast injuries

Cited by 343 publications

References 111 publications

Standardizing Data Collection in Traumatic Brain Injury

Standardizing Data Collection in Traumatic Brain Injury

Development of an Animal Model for Burn-Blast Combined Injury and Cardiopulmonary System Changes in the Early Shock Stage

Prospects for studying how high-intensity compression waves cause damage in human blast injuries

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