Radiation injury after a nuclear detonation: medical consequences and the need for scarce resources allocation.
Radiation injury after a nuclear detonation: medical consequences and the need for scarce resources allocation.
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DOI：
10.1001/dmp.2011.17
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发表时间：
2011-03
影响因子：
2.7
通讯作者：
Weinstock, David M.
中科院分区：
文献类型：
--
作者：
DiCarlo, Andrea L.;Maher, Carmen;Hick, John L.;Hanfling, Dan;Dainiak, Nicholas;Chao, Nelson;Bader, Judith L.;Coleman, C. Norman;Weinstock, David M.
在美国一座城市内发生的10千吨(KT)核爆炸可能会使数十万人受到辐射。开展核爆炸稀缺资源项目是为了指导社区规划和应对核爆炸后的情况，因为在这种情况下，需求将大大超过可用资源。本文回顾了有关人类暴露和动物模型辐射损伤的文献，为本期特刊概述的分类和管理方法提供了基础。全身剂量>；2Gy会产生临床显著的急性辐射综合征(ARS)，典型的累及血液学、胃肠道、皮肤和心血管/中枢神经系统。ARS的严重程度和表现受多种因素的影响，包括辐射剂量和剂量率、辐射反应的个体间变异性、辐射类型(例如，伽马单独、伽马加中子)、局部身体屏蔽，以及可能的年龄、性别和某些既往的医疗条件。放射治疗合并创伤、烧伤或两者兼而有之(即复合损伤)比单纯接受相同剂量的放射治疗预后更差。支持性护理措施，包括液体支持、抗生素和可能的髓系细胞因子(如粒细胞集落刺激因子)，可以改善一些辐射伤员的预后。最后，可从辐射紧急医疗管理网站和辐射损伤治疗网络获得针对急性呼吸窘迫综合征伤员的专家指导和应急能力。
A 10-kiloton (kT) nuclear detonation within a US city could expose hundreds of thousands of people to radiation. The Scarce Resources for a Nuclear Detonation Project was undertaken to guide community planning and response in the aftermath of a nuclear detonation, when demand will greatly exceed available resources. This article reviews the pertinent literature on radiation injuries from human exposures and animal models to provide a foundation for the triage and management approaches outlined in this special issue. Whole-body doses >2 Gy can produce clinically significant acute radiation syndrome (ARS), which classically involves the hematologic, gastrointestinal, cutaneous, and cardiovascular/central nervous systems. The severity and presentation of ARS are affected by several factors, including radiation dose and dose rate, interindividual variability in radiation response, type of radiation (eg, gamma alone, gamma plus neutrons), partial-body shielding, and possibly age, sex, and certain preexisting medical conditions. The combination of radiation with trauma, burns, or both (ie, combined injury) confers a worse prognosis than the same dose of radiation alone. Supportive care measures, including fluid support, antibiotics, and possibly myeloid cytokines (eg, granulocyte colony-stimulating factor), can improve the prognosis for some irradiated casualties. Finally, expert guidance and surge capacity for casualties with ARS are available from the Radiation Emergency Medical Management Web site and the Radiation Injury Treatment Network.
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影响因子：
5.2
作者：
Fliedner, Theodor M.;Chao, Nelson J.;Bader, Judith L.;Boettger, Axel;Case, Cullen, Jr.;Chute, John;Confer, Dennis L.;Ganser, Arnold;Gorin, Norbert-Claude;Gourmelon, Patrick;Graessle, Dieter H.;Krawisz, Robert;Meineke, Viktor;Niederwieser, Dietger;Port, Matthias;Powles, Ray;Sirohi, Bhawna;Weinstock, David M.;Wiley, Albert;Coleman, C. Norman
通讯作者：
Coleman, C. Norman
影响因子：
3.6
作者：
BAXTER, H;DRUMMOND, JA;RANDALL, RG
通讯作者：
RANDALL, RG
DOI：
10.1016/0013-4694(53)90013-3
发表时间：
1953-01-01
期刊：
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY
影响因子：
--
作者：
ELDRED, E;TROWBRIDGE, WV
通讯作者：
TROWBRIDGE, WV
影响因子：
2.6
作者：
Fliedner, Theodor M.;Graessle, Dieter;Doorr, Harold
通讯作者：
Doorr, Harold
DOI：
10.1097/00005373-199312000-00007
发表时间：
1993-12-01
影响因子：
--
作者：
CHEADLE, WG;PEMBERTON, RM;POLK, HC
通讯作者：
POLK, HC