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

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.