Acute brain and cardiorespiratory dysfunction after blast/blunt injuries: The life-preserving effects of hyperbaric oxygenation

Today there is an ever-growing necessity to use more aggressive and pathophysiologically adequate techniques in emergency and intensive care in the early stages of modern bombing/blast injuries. The purpose of this review is to present modern data regarding the pathophysiology of the early period of blast injury, focusing on the impairment of hemodynamics and respiration, and mainly on the role of acute cardiorespiratory and brain dysfunction in the pathogenesis of severe and critical conditions due to blast/blunt injuries. The literature analysis we understook emphasizes the crucial role of early impairment of myocardial contractility in the pathogenesis and outcome of severe traumas established over the course of the last decade in experimental and clinical studies. This review presents the results of laboratory and clinical observations, evidencing the principally important, life-saving effects of the early application of hyperbaric oxygenation in order to correct life-threatening dysfunctions of vital organs (brain, heart, and lungs) resulting from trauma, and to prevent the development of such conditions when trauma consequences are less severe. Also, new data are presented on the possible mechanisms of the protective effects of hyperbaric oxygenation in cases of severe chest and head injuries. On the basis of the available literature, we consider the desirability of establishing and employing mobile hyperbaric oxygenation chambers in emergency hyperbaric medicine.