TY  - JOUR
PY  - 1999//
TI  - Shock after blast wave injury is caused by a vagally mediated reflex
JO  - Journal of trauma
A1  - Tuggle, D. W.
A1  - Brackett, Daniel J.
A1  - Mantor, P. C.
A1  - Bealer, J. F.
A1  - Lerner, M. R.
A1  - Irwin, R. John
SP  - 105
EP  - 110
VL  - 47
IS  - 1
N2  - OBJECTIVE: Bomb blast survivors occasionally suffer from profound shock and hypoxemia without signs of external injury. We hypothesize that a vagally mediated reflex such as the pulmonary defensive reflex is the cause of shock from blast wave injury. This study was a prospectively randomized, controlled animal study. METHODS: By using a previously described model of blast wave injury, we randomized rats to one of four groups: control, blast-only, bilateral cervical vagotomy plus atropine 200 microg/kg i.p. only, and bilateral cervical vagotomy plus atropine 200 microg/kg i.p. before blast injury. Cardiopulmonary parameters were recorded for 90 minutes after the blast or until death. RESULTS: Bradycardia, hypotension, and absence of compensatory peripheral vasoconstriction, typically seen in animals subjected to a blast pressure injury, were prevented by bilateral cervical vagotomy and intraperitoneal injection of atropine methyl-bromide. Hypoxia and lung injury were not statistically significant between the blasted groups, suggesting equivalent injury. CONCLUSION: Our data implicate a vagally mediated reflex such as the pulmonary defensive reflex as the cause of shock seen immediately after a blast pressure wave injury.
LA  - 
SN  - 0022-5282
UR  - http://dx.doi.org/
ID  - ref1
ER  -