• Andrew Lumley, Erik Osborn, Adrian Mellor, Elise LaCroix, George Johnson, Mary Wallace, Mike Stacey, Jason E Smith, and David Woods.
• 335 Medical Evacuation Regiment, Queen Elizabeth Barracks, York, UK; East Anglian Air Ambulance, Norwich, UK. Electronic address: andrewlumley@nhs.net.
• J Crit Care. 2018 Feb 1; 43: 312-315.

PurposeTo study the relationship between serum neutrophil gelatinase-associated lipocalin (NGAL) and military blast and gunshot wound (GSW) to establish whether potential exists for NGAL as a biomarker for blast lung injury (BLI).MethodPatients from the intensive care unit (ICU) of the Role 3 Medical Treatment Facility at Camp Bastion, Helmand Province, Afghanistan were studied over a five month period commencing in 2012. Age, mechanism, trauma injury severity score (TRISS) and serum NGAL were recorded on ICU admission (NGAL1). Serum NGAL (NGAL2) and PaO2/FiO2 ratio (P/F ratio2) were recorded at 24h.Results33 patients were injured by blast and 23 by GSW. NGAL1 inversely correlated with TRISS (p=0.020), pH (p=0.002) and P/F ratio 2 (p=0.009) overall. When data was stratified into blast and GSW, NGAL1 also inversely correlated with P/F ratio 2 in the blast injured group (p=0.008) but not GSW group (p=0.27).ConclusionRaised NGAL correlated with increased severity of injury (worse survival probability i.e. TRISS and low pH) in both patient groups. There was an inverse correlation between admission NGAL and a marker of blast lung injury (low P/F ratio) at 24h in blast injured group but not GSW group that warrants further investigation.Copyright © 2017 Elsevier Inc. All rights reserved.

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