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(Chest. 1999;116:1683-1688.)
© 1999 American College of Chest Physicians

Recovery From Blast Lung Injury*

One-Year Follow-up

Boaz Hirshberg, MD; Arieh Oppenheim-Eden, MD; Reuven Pizov, MD; Miri Sklair-Levi, MD; Abraham Rivkin, MD; Elat Bardach; Mili Bublil; Charles Sprung, MD, FCCP and Mordechai R. Kramer, MD, FCCP

* From the Division of Medicine (Dr. Hirshberg), Department of Anesthesiology and Critical Care Medicine (Drs. Oppenheim-Eden, Pizov, and Sprung), Department of Radiology (Dr. Sklair-Levi), Department of Surgery (Dr. Rivkin), and the Institute of Pulmonology (Ms. Bardach), Hadassah University Hospital, Hebrew University Medical School, Jerusalem; and Rabin Medical Center (Ms. Bublil and Dr. Kramer), Petach Tikva, Israel.

Correspondence to: Mordechai R. Kramer, MD, FCCP, Institute of Pulmonology, Rabin Medical Center, Petach Tikva 49100, Israel

Background: Blast injury to the lung is one of the devastating threats facing victims of an explosion. Although the pathogenesis of blast injury has been studied, little is known about the long-term effects on lung function in survivors.

Objective: To examine the pulmonary function of survivors 1 year after sustaining a blast injury.

Design: Prospective study.

Setting: Pulmonary function test laboratory at Hadassah Medical Center, Jerusalem.

Participants: Eleven surviving victims of a blast injury sustained during a bus terrorist explosion.

Measurements: Twelve months after the injury, physical examinations, lung function tests, and progressive cardiopulmonary exercise examinations were conducted, and chest radiographs were obtained.

Results: The average age was 28 ± 9.8 years. Most of the victims had multiple injuries in addition to the lung injury. Ten patients received mechanical ventilation, and 6 patients required chest drainage. All patients were treated in the ICU, with an average stay of 11.8 ± 9 days. The patients were discharged to their homes or to a rehabilitation center 32.4 ± 27.3 days after the explosion. One year later, none had any pulmonary-related complaints. Physical examination of the lungs was normal. Most of the patients demonstrated normal lung function tests and complete resolution of the chest radiograph findings.

Conclusion: Most patients who survive lung blast injury will regain good lung function within a year.

Key Words: ARDS • blast • lung injury • pneumothorax






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