{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:45:21Z","timestamp":1783079121456,"version":"3.54.6"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5-6","funder":[{"name":"Surgeon General\u2019s research fund, Ministry of Defence"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,8]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Primary blast lung injury occurs when an explosive shock wave passes through the thorax and transits through tissues of varying densities. It requires close proximity to an explosion and presents quick with respiratory distress in survivors.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n The Joint Theatre Trauma Registry and the Defence Statistics (Health) Database were interrogated for casualties injured as a result of an explosion during the conflict in Afghanistan. The case notes and imaging of casualties meeting the criteria for diagnosis were reviewed. Demographic and clinical data on casualties with primary blast lung injury were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 848 blast-exposed casualties survived to discharge from intensive care, and 238 blast-exposed casualties were killed in action. Following exclusions, 111 case notes and all postmortem reports were reviewed in detail. About, 25 casualties had isolated primary blast lung injury (2.9% of casualties surviving to discharge from intensive care) and 31 nonsurvivors (13% of nonsurvivors) had the disease documented at postmortem. Severe cases of primary blast lung injury required an estimated average of 4.5\u00a0days of conventional mechanical ventilation.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n 8.1% of blast exposed casualties suffered primary blast lung injury. It was a less severe disease than other nontraumatic forms of acute lung injury and did not cause deaths once a casualty had reached a combat support hospital. It was well managed with a relatively brief period of conventional mechanical ventilation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/milmed\/usz453","type":"journal-article","created":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T06:40:27Z","timestamp":1577342427000},"page":"e568-e572","source":"Crossref","is-referenced-by-count":18,"title":["Primary Blast Lung Injury: The UK Military Experience"],"prefix":"10.1093","volume":"185","author":[{"given":"Timothy E","family":"Scott","sequence":"first","affiliation":[{"name":"Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, ICT Centre, Birmingham B15 2SQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M","family":"Johnston","sequence":"first","affiliation":[{"name":"Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, ICT Centre, Birmingham B15 2SQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian D","family":"Keene","sequence":"first","affiliation":[{"name":"Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, ICT Centre, Birmingham B15 2SQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenal","family":"Rana","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Glenfield Hospital, Groby Road, Leicester, LE3 9QP UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F","family":"Mahoney","sequence":"first","affiliation":[{"name":"Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, ICT Centre, Birmingham B15 2SQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,24]]},"reference":[{"issue":"4","key":"2020060910343220100_ref1","first-page":"303","article-title":"What the intensive care doctor needs to know about blast-related lung injury","volume":"14","author":"Mackenzie","year":"2013","journal-title":"Society"},{"key":"2020060910343220100_ref2","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1186\/cc3762","article-title":"The Israeli experience: conventional terrorism and critical care","volume":"9","author":"Aschkenasy-Steuer","year":"2005","journal-title":"Crit Care"},{"key":"2020060910343220100_ref3","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1097\/00005373-199812000-00001","article-title":"Physiologic responses to primary blast","volume":"45","author":"Guy","year":"1998","journal-title":"J Trauma"},{"key":"2020060910343220100_ref4","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1093\/bja\/aew385","article-title":"Primary blast lung injury\u2013A review","volume":"118","author":"Scott","year":"2017","journal-title":"Br J Anaesth"},{"key":"2020060910343220100_ref5"},{"key":"2020060910343220100_ref6","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/cc2995","article-title":"11 March 2004: the terrorist bomb explosions in Madrid, Spain\u2014an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital","volume":"9","author":"de Ceballos","year":"2005","journal-title":"Crit Care"},{"issue":"1","key":"2020060910343220100_ref7","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1378\/chest.115.1.165","article-title":"Blast lung injury from an explosion on a civilian bus","volume":"115","author":"Pizov","year":"1999","journal-title":"Chest"},{"issue":"4","key":"2020060910343220100_ref8","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1136\/jramc-153-04-04","article-title":"Governance and data collection trauma governance in the UK defence medical services major trauma audit for clinical effectiveness (MACE)","volume":"153","author":"Smith","year":"2007","journal-title":"J R Army Med Corps"},{"key":"2020060910343220100_ref9"},{"key":"2020060910343220100_ref10","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1098\/rstb.2010.0232","article-title":"The role of trauma scoring in developing trauma clinical governance in the Defence Medical Services","volume":"366","author":"Russell","year":"2011","journal-title":"Philos Trans R Soc B"},{"issue":"23","key":"2020060910343220100_ref11","first-page":"2526","article-title":"Acute respiratory distress syndrome: the Berlin definition","volume":"307","author":"Ranieri","year":"2012","journal-title":"JAMA"},{"key":"2020060910343220100_ref12","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/2110-5820-4-4","article-title":"Is there still a role for the lung injury score in the era of the Berlin definition ARDS?","volume":"4","author":"Kangelaris","year":"2014","journal-title":"Ann Intensive Care"},{"issue":"10","key":"2020060910343220100_ref13","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1002\/bjs.1800761006","article-title":"Analysis of 828 servicemen killed or injured by explosion in Northern Ireland 1970-84: the hostile action casualty system","volume":"76","author":"Mellor","year":"1989","journal-title":"Br J Surg"},{"issue":"3","key":"2020060910343220100_ref14","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1097\/CCM.0000000000003499","article-title":"An analysis of the acute respiratory distress syndrome network trials","volume":"47","author":"Zhang","year":"2019","journal-title":"Crit Care Med"},{"issue":"1","key":"2020060910343220100_ref15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/MCC.0000000000000057","article-title":"The acute respiratory distress syndrome and mortality, has it changed?","volume":"20","author":"Villar","year":"2014","journal-title":"Curr Opin Crit Care"},{"key":"2020060910343220100_ref16","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/01.CCM.0000108870.09693.42","article-title":"Effect of acute lung injury and acute respiratory distress syndrome on outcomes in critically ill trauma patients","volume":"32","author":"Treggiari","year":"2004","journal-title":"Crit Care Med"},{"key":"2020060910343220100_ref17","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1164\/rccm.200310-1434OC","article-title":"Significance of von Willebrand factor in septic and nonseptic patients with acute lung injury","volume":"170","author":"Ware","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"issue":"10","key":"2020060910343220100_ref18","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1097\/01.CCM.0000280434.33451.87","article-title":"Trauma-associated lung injury differs clinically and biologically from acute lung injury due to other clinical disorders","volume":"35","author":"Calfee","year":"2007","journal-title":"Crit Care Med"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/5-6\/e568\/33370206\/usz453.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/5-6\/e568\/33370206\/usz453.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T14:34:57Z","timestamp":1591713297000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/185\/5-6\/e568\/5686330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,24]]},"references-count":18,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2019,12,24]]},"published-print":{"date-parts":[[2020,6,8]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usz453","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,5]]},"published":{"date-parts":[[2019,12,24]]}}}