The lung function after mine explosion wounds

Background. Combined gunshot wounds (GSWs) causes hypoxic disorders, most pronounced in cases of damage to the chest. However, with any severe gunshot injury, all the organs are susceptible to varying degrees of contusion injury, and massive blood loss triggers a cascade of pathophysiological reactions leading to acute lung damage.

Aim. To study the lung function in various periods after severe GSWs of non-thoracic localization.

Materials and methods. The study included 30 patients with a diagnosis of combined combat injury, 100% men, 100% smokers, median age 37 years. The median period from injury (Me) was 63.5 (28–136) days.

Results. A prospective cross-sectional study was performed. The total sample was divided into groups: group 1–19 patients with combined GSWs received over a period of 3 months, group 2–11 patients with combined GSWs received more than 3 months ago from the date of the study. All patients underwent spirometry, body plethysmography, and a diffusion test. In the total group, 3 patients had obstructive ventilation disorders, 37% (11/30, most of whom suffered injuries to their limbs) had impaired lung diffusion capacity (decreased DLco). In addition, in group 2, lower values of forced exhalation volume in 1 second are noteworthy (FEV₁ 115% pred. and 102% pred. in groups 1 and 2, respectively; p=0.01) and a higher incidence of decreased DLco (in 21% and 64% of cases in groups 1 and 2, respectively; p=0.026).

Conclusion. Special attention should be paid to the lung function in patients with severe traumatic limb injuries. Due to massive blood loss and shock in the early post-traumatic period, a cascade of pathophysiological reactions is triggered, leading to damage to lung tissue of varying severity, which can subsequently lead to functional disorders of the respiratory system, primarily a decreased diffusion capacity of lungs.