Characterization of crash-induced thoracic loading resulting in pulmonary contusion

Gayzik, F. Scott; Martin, R. Shayn; Gabler, H. Clay; Hoth, J. Jason; Duma, Stefan M.; Meredith, J. Wayne; Stitzel, Joel D.

Affiliations

¹Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina

²Department of Biomedical Engineering, Virginia Tech – Wake Forest University Center for Injury Biomechanics

³Department of General Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina

⁴Department of Mechanical Engineering, Virginia Tech, Blacksburg, Virginia

Abstract and keywords

Background: Pulmonary contusion (PC) is commonly sustained in motor vehicle crash. This study utilizes the Crash Injury Research and Engineering Network (CIREN) database and vehicle crash tests to characterize the occupants and loading characteristics associated with PC. A technique to match CIREN cases to vehicle crash tests is applied to quantify the thoracic loading associated with this injury.

Methods: The CIREN database and crash test data from the National Highway Traffic Safety Administration were used in this study. An analysis of CIREN data were conducted between three study cohorts: patients that sustained PC and any other chest injury (PC+ and chest+), patients with chest injury and an absence of PC (PC- and chest+), and a control group without chest injury and an absence of PC (PC- and chest-). Forty-one lateral impact crash tests were analyzed and thoracic loading data from onboard crash tests dummies were collected.

Results: The incidence of PC in CIREN data were 21.7%. Crashes resulting in PC demonstrated significantly greater mortality (23.9%) and Injury Severity Score (33.1 ± 15.7) than the control group. The portion of lateral impacts increased from 27% to 48% between the control group and PC+ and chest+ cohort, prompting the use of lateral impact crash tests for the case-matching portion of the study. Crash tests were analyzed in two configurations; vehicle-to-vehicle tests and vehicle-to-pole tests. The average maximum chest compression and deflection velocity from the dummy occupants were found to be 25.3% ± 2.6% and 4.6 m/s ± 0.42 m/s for the vehicle-to-pole tests and 23.0% ± 4.8% and 3.9 m/s ± 1.1 m/s for the vehicleto-vehicle tests. Chest deflection versus time followed a roughly symmetric and sinusoidal profile. Sixteen CIREN cases were identified that matched the vehicle crash tests. Of the 16 matched cases, 12 (75%) sustained chest injuries, with half of these patients presenting with PC.

Conclusions: Quantified loading at the chest wall indicative of PC and chest injury in motor vehicle crash is valuable boundary condition data for bench-top studies or computer simulations focused on this injury. In addition, because PC often exhibits a delayed onset, knowing the population and crash modes highly associated with this injury may promote earlier detection and improved management of this injury.

Keywords: Pulmonary contusion, Thorax, Motor vehicle crash, Biomechanics, CIREN, Compression, Experiment

Links

DOI: 10.1097/TA.0b013e318186251e

PubMed: 19276763

WoS: 000264259000041

History

Received: 2007-07-26

Accepted: 2008-07-09

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2009	Gayzik FS, Hamilton CA, Tan JC, McNally C, Duma SM, Klinich KD, Stitzel JD. A multi-modality image data collection protocol for full body finite element model development. SAE Digital Human Modeling for Design and Engineering; June 9-11, 2009; Gothenburg, Sweden. SAE 2009-01-2261.
2011	Danelson KA, Chiles C, Thompson AB, Donadino K, Weaver AA, Stitzel JD. Correlating the extent of pulmonary contusion to vehicle crash parameters in near-side impacts. In: 55th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 3-5, 2011; Paris, France.217-230.
2017	Gaewsky J, Jones D, Weaver A, Stitzel J. A numerical approach to identify injury risk regions within soft tissues of dynamic human body finite element models. In: Proceedings of the 25th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 5-8, 2017; Detroit, MI.
2010	Danelson KA, Weaver AA, Gayzik FS, Stitzel JD. Correlating the extent and location of pulmonary contusion to vehicle crash parameters. In: Proceedings of the 38th International Workshop on Human Subjects for Biomechanical Research. 2010.
2010	Kemper AR, Beeman SM, Duma SM. Chest deflection of relaxed and braced human occupants in low severity frontal sled tests and non-censored rib fracture data in high severity PMHS frontal sled tests. In: Proceedings of the 38th International Workshop on Human Subjects for Biomechanical Research. 2010.
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2021	Suntay B, Stammen J, Carlson M, Ramachandra R. Abdominal and thoracic injury risk functions for the large omni-directional child (LODC) ATD. In: Proceedings of the 2021 International IRCOBI Conference on the Biomechanics of Injury. September 8-10, 2021; Online.537-555.
2011	Kemper AR, Kennedy EA, McNally C, Manoogian SJ, Stitzel JD, Duma SM. Reducing chest injuries in automobile collisions: rib fracture timing and implications for thoracic injury criteria. Ann Biomed Eng. August 2011;39(8):2141-51.
2011	Gayzik FS, Moreno DP, Geer CP, Wuertzer SD, Martin RS, Stitzel JD. Development of a full body CAD dataset for computational modeling: a multi-modality approach. Ann Biomed Eng. October 2011;39(10):2568-2583.
2011	Beeman SM, Kemper AR, Madigan ML, Duma SM. Effects of bracing on human kinematics in low-speed frontal sled tests. Ann Biomed Eng. December 2011;39(12):2998-3010.
2013	Vavalle NA, Moreno DP, Rhyne AC, Stitzel JD, Gayzik FS. Lateral impact validation of a geometrically accurate full body finite element model for blunt injury prediction. Ann Biomed Eng. 2013;41(3):497-512.
2011	Gayzik FS, Hoth JJ, Stitzel JD. Finite element–based injury metrics for pulmonary contusion via concurrent model optimization. Biomech Model Mechanobiol. 2011;10(4):505-520.
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2012	Daniel RW II. Head Acceleration Measurements in Helmet-Helmet Impacts and the Youth Population [Master's thesis]. Virginia Polytechnic Institute and State University; April 16, 2012.
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