Blast Lung Injury

28 November 2011

Dr Iain Mackenzie

Consultant in Intensive Care Medicine and Anaesthesia
Queen Elizabeth Hospital Birmingham

Dr Iain Mackenzie provided an intriguing look into one of the most complex types of injury suffered by military patients: blast lung injury.

This condition develops as the result of the passage of a blast wave through the body, caused by the detonation of a nearby explosive device. The energy form the blast wave propagates through the body and causes the most damage as it passes from a dense medium to a less dense medium.

The lungs, where gasses interact directly with large areas of delicate tissue, can suffer serious injury as a result. Dr Mackenzie likened the effect to that of an underwater detonation, with the blast wave lifting the surface of the water and then eventually breaking the surface. In this example, the surface of the water is compared with the surface of the long tissues.

The effect on the lungs can be very serious, reducing the patient’s ability to draw oxygen into the bloodstream and thereby reducing the efficiency of physiological processes, including healing.

However, the injury is often not diagnosed due to a surgical and medical focus on larger injuries suffered by the patient in the blast. Explosions can cause very serious damage, including traumatic amputation of limbs, eye injuries, organ rupture and burns. These life-threatening injuries can cause blast lung injury to go undiagnosed.

Dr Mackenzie is carrying out initial work on providing a more rigorous definition of blast lung injury, a label which has previously been applied to a wide range of conditions associated with lung and torso injuries.

He is also aiming to establish the value of blast lung injury diagnostic testing as a standard procedure for all patients exposed to blasts.