Value of lung ultrasound score for evaluation of blast lung injury in goats

Purpose:To establish a severe blast lung injury model of goats and investigate the feasibility of lung ultrasonic score in the evaluation of blast lung injury.Methods:Twenty female healthy goats were randomly divided into three groups by different driving pressures:4.0 MPa group(n=4),4.5 MPa group(n=12)and 5.0 MPa group(n=4).The severe blast lung injury model of goats was established using a BST-I bio-shock tube.Vital signs(respiration,heart rate and blood pressure),lung ultrasound score(LUS),PO2/FiO2 and extravascular lung water(EVLW)were measured before injury(0 h)and at 0.5 h,3 h,6 h,9 h,12 h after injury.Computed tomography scan was performed before injury(0 h)and at 12 h after injury for dynamic monitoring of blast lung injury and measurement of lung volume.The correlation of LUS with PaO2/FiO2,EVLW,and lung injury ratio(lesion volume/total lung volume*100%)was analyzed.All animals were sacrificed at 12 h after injury for gross observation of lung injury and histopathological examination.Statistical analysis was performed by the SPSS 22.0 software.The measurement data were expressed as mean±standard deviation.The means of two samples were compared using independent-sample t-test.Pearson correlation analysis was conducted.Results:(1)At 12 h after injury,the mortality of goats was 0,41.67% and 100%in the 4.0 Mpa,4.5 MPa and 5.0 MPa groups,respectively;the area of pulmonary hemorrhage was 20.00%±13.14% in the 4.0 Mpa group and 42.14%±15.33% in the 4.5 MPa group.A severe lung shock injury model was established under the driving pressure of 4.5 MPa.(2)The respiratory rate,heart rate,LUS and EVLW were significantly increased,while PaO2/FiO2 was significantly reduced immediately after injury,and then they gradually recovered and became stabilized at 3 h after injury.(3)LUS was positively correlated with EVLW(3 h:r=-0.597,6 h:r=-0.698,9 h:r=-0.729;p<0.05)and lung injury ratio(12 h:r=-0.884,p<0.05),negatively correlated with PaO2/FiO2(3 h:r=-0.871,6 h:r=-0.637,9 h:r=-0.658;p<0.05).Conclusion:We established a severe blast lung injury model of goats using the BST-I bio-shock tube under the driving pressure of 4.5 MPa and confirmed that ultrasound can be used for quick evaluation and dynamic monitoring of blast lung injury.