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What is the effectiveness of lung assist devices in blast lung injury: A Literature Review
Journal article   Peer reviewed

What is the effectiveness of lung assist devices in blast lung injury: A Literature Review

Benjamin R Mackie
Journal of Military and Veterans' Health, Vol.16(1), pp.17-24
2007
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http://search.informit.com.au/documentSummary;dn=512232733882207;res=IELHEAView
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Abstract

Public Health and Health Services Clinical Sciences Dentistry
Blast lung injury (BLI) is a direct consequence of a blast wave from high explosive detonations upon the body. The physics of a blast wave are nonlinear and complex. The primary blast effects are most significant at air fluid interfaces such as the ear, lung and gastrointestinal tract. Of these air-fluid containing organs, the lung is most susceptible to the primary blast effects and the extent of lung injury is considered a decisive parameter in defining morbidity and mortality for blast victims both at the scene and among initial survivors. The clinical sequel of BLI is a rapid respiratory deterioration and progressive hypoxia with resultant ventilation perfusion mismatch and subsequent acute respiratory distress syndrome (ARDS). All patients with significant BLI require mechanical ventilation and admission to ICU. The rationale for using the LAD in BLI is not primarily to improve oxygenation, but more to minimise ventilator associated lung injury, and to ameliorate and eliminate the inflammatory process that is enhanced by mechanical ventilation. The notion of a lung assist device (LAD) was first raised in 1967 by Rash kind who proposed a pumpless oxygenator for temporary lung assist in cystic fibrosis, ARDS and congenital heart disease. The aim of this paper is to identify through an extensive literature review: (1) the effectiveness of LAD in BLI; and (2) the recommended treatment modalities for BLI. This paper will also provide current information ensuring that medical and nursing staff within theAustralian critical care setting become familiar with the management of BLI.

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