Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles

Fortunately, radiation accidents are infrequent occurrences, but since they have the potential of resulting in large scale events, such as the nuclear accidents of Chernobyl and Fukushima, preparatory planning for medical management of radiation accident victims is very important [1].Radiation accidents can result in radiation exposure to only a few up to several hundreds of people, depending on the type of accident and the amount of radiation exposure. Radiation exposure can occur as external exposure, for instance, from a sealed radiation source, or as internal exposure due to the intake of radionuclides. In a nuclear disaster scenario like the Chernobyl accident, a combination of external and internal radiation exposure could occur. Radiation exposure can also be categorized as either chronic or acute, depending on the period of time of radiation exposure. Another important factor that can effect treatment and outcome is whether the whole body of a person was affected homogeneously or if only localized radiation exposure of a part of the body occurred.For each of these different types of scenarios and combinations the expected consequences for the patient, depending on the absorbed radiation dose and distribution as well as diagnostic and therapeutic measures, are different. In the case of whole body exposure, all organs and organ systems are affected and, therefore, multi-organ-involvement and multi-organ-failure have always to be taken into account. Additional conventional trauma, such as wounds and burns in people with severe radiation exposure - the so-called radiation combined injury, could worsen the prognosis [2].There are many aspects to consider when diagnosing and managing radiation exposed patients. Acute versus chronic effects can be differentiated by the latency of manifestation of the radiation effects. Since acute effects require immediate therapeutic intervention, they should be diagnosed at an early stage. Another differentiation could be made be