Development of a Severe Blast Lung Injury Model in a Goat for Ultrasonographic Evaluation

Summary

This study successfully established a severe blast lung injury model in goats at a driving pressure of 4.5 MPa, causing significant injury and 41.67% mortality. Lung ultrasound scoring dynamically assessed damage, correlating with traditional indicators, demonstrating its diagnostic value. This reproducible model advances diagnostics and therapies for acute lung injury.

Abstract

Blast lung injury (BLI) causes severe lung damage and high morbidity, especially in military and industrial settings, leading to hemorrhage and potential respiratory failure, highlighting the need for improved diagnostics and treatments. This study aimed to develop a standardized severe BLI model in goats to evaluate the accuracy and feasibility of point-of-care ultrasound for dynamic assessment. Goats were subjected to controlled blast overpressure using the biologic shock tube (BST-Ⅰ) at driving pressures of 4.0 MPa (n = 4), 4.5 MPa (n = 12), and 5.0 MPa (n = 4), respectively. Key parameters, such as peak overpressure, were recorded. Vital signs, lung ultrasound scoring (LUS), oxygenation index (PaO₂/FiO₂), and extravascular lung water (EVLW) were monitored at baseline (0 h pre-injury) and 0.5 h, 3 h, 6 h, 9 h, 12 h post-injury. Thoracic computed tomography (CT) at 0 h and 12 h quantified lung injury ratio, and gross examination post-euthanasia assessed pulmonary hemorrhage and injury score. At 4.5 MPa, the peak overpressure was 396.92 kPa, with a 41.67% mortality rate post-injury, whereas at 4.0 MPa, the mortality rate was 0%. LUS increased over time, showing a negative correlation with PaO₂/FiO₂ and a positive correlation with EVLW at 3 h, 6 h, and 9 h, and a positive correlation with lung injury ratio at 12 h. Gross lung injury area ratio was 42.14% in the 4.5 MPa group, indicating severe injury, while 4.0 MPa showed moderate injury. The 4.5 MPa model was suitable for studying severe injury, unlike 4.0 MPa, which caused only moderate injury, and 5.0 MPa resulted in 100% mortality. A reproducible goat model of blast lung injury was established, effectively using LUS to non-invasively assess pulmonary damage over time, providing a basis for monitoring and exploring therapeutic strategies for acute lung injury.

Introduction

Blast exposures, whether in military or civilian settings, continue to represent a major contributor to morbidity and mortality, with lung injury being a primary determinant of outcome¹. Contemporary evidence confirms that pulmonary contusion is a critical risk factor for severe respiratory complications, such as pneumonia and acute respiratory distress syndrome (ARDS), which significantly impact the prognosis of affected individuals². Prompt and precise evaluation of the extent of lung injury is therefore essential to guide clinical management and improve survival.

Computed tomography (CT) is....

Protocol

All experimental methodologies detailed in this manuscript received approval from the Laboratory Animal Welfare and Ethics Committee of the Third Military Medical University (SCXK (Yu) 2017-0002). Furthermore, all animal-related procedures were carried out in strict compliance with the animal use guidelines established by the approval committee.

1. Experimental animals

1. Prepare healthy goats, 3–6 months old, female, weighing around 15 kg.

2. Injury platform

1. Cause lung blast injuries by biologic shock tube (the large one) (BST-Ⅰ), which is....

Results

In the 4.5 MPa group, the measured injury parameters are as follows: peak overpressure 396.92 ± 23.11 kPa, rise time 9.41 ± 0.32 ms, positive phase duration 51.57 ± 1.39 ms, and positive phase impulse 5884.26 ± 231.44 kPa.ms. The pressure-time profile of the shock wave is shown in Figure 5. In the 4.0 MPa cohort, the mortality rate was 0% both immediately post-injury and at 12 h. In the 4.5 MPa cohort, the immediate post-injury mortality rate was 16.67% (2/12), which increased to 41.67% (5/1.......

Discussion

Blast lung injury is a severe condition resulting from exposure to explosive blasts. It is characterized by pulmonary parenchymal damage, alveolar hemorrhage, inflammation, and coagulation disorders, and frequently progresses to ARDS with high mortality^11,12,13. Current diagnostic methods include CT for detailed morphological assessment^3,14 and techniques such as esophag.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
64-slice CT scanner	GE Lightspeed, USA	5133730-3
Babylog 8000	Dräger, Germany	https://www.draeger.com/en_in/Products/Babylog-8000-plus
Biologic shock Tube (the large one) (BST-I)	Daping Hosipital, Army Medical University	BST-I
CG4+ test cartridge	Abbott, USA	CG4+
Double-lumen central venous catheter	Braun, Germany	Duo V730
Electric Suction Apparatus	Jiangsu Yuyue Medical Equipment & Supply Co., Ltd.	7A-23D
Endotracheal tube	TAMPA, Hangzhou	ETT6014C
Heparin Sodium	Changzhou Qianhong Bio-pharma Co., Ltd.
I.V.Catheter for single use	Weihai Jierui Medical Products Co., Ltd.	22G × 25mm/Y-G
ImageJ software
IOTech  WaveView 7.15.6 software	IOtech, USA	https://iotechsoftware.com/
Midazolam	Nhwa Pharma Co. China	http://pharma-api.com/2-2-5-midazolam-injection/
PCB  sensor	PCB Piezotronics, Inc. (USA)	M102A02
Pentobarbital sodium	Shanghai Pharmaceutical	NA
Philips IntelliSpace Portal workstation		https://www.philips.ca/healthcare/product/HC881101/intellispace-portal-12
Picco Monitoring Kit	PULSION, Germany	PV8215
Portable blood gas analyzer	Abbott, USA	i-STAT 300G
Portable wireless color ultrasound device	Youkey Bio-Medical Electronics Co., China	D-236
Veet pure hair removal cream	Reckitt Benckiser	https://www.veet.co.in/en/products/hair-removal-creams/