Table 2.
Evolution of blast lung.
| event | apparent clinical problem | time (h) |
|---|---|---|
| shock wave damage | 0 | |
| rupture of alveolar capillaries | ||
| blood into interstitium and alveoli | reduced gas transfer (esp O2) | |
| free Hb and blood | inflammation | |
| free radicals/oxidative stress | ||
| augmented inflammatory response | ||
| more oedema | reduced gas transfer (esp O2) | |
| leucocyte accumulation | more inflammation and reduced gas transfer | 3 |
| more oxidative stress, inflammation and oedema | ||
| epithelial cell damage evident | further impairment | 12–24 |
| endothelial cell damage evident | lung mechanics | 24–56 |