Understanding of the cellular immune response to primary blast lung injury (PBLI) is limited, with only the neutrophil response well documented. Moreover, its impact on the immune response in distal organs remains poorly understood. In this study, a rodent model of isolated primary blast injury was used to investigate the acute cellular immune response to isolated PBLI in the circulation and lung; including the monocyte response, and investigate distal sub-acute immune effects in the spleen and liver 6hr after injury.Rats were subjected to a shock wave (~135kPa overpressure, 2ms duration) inducing PBLI or sham procedure. Rat physiology was monitored and at 1, 3 and 6 hr thereafter blood, lung, and Broncho-alveolar lavage fluid (BALF) were collected and analysed by flow cytometry (FCM), ELISA and Histology. In addition, at 6hr spleen and liver were collected and analysed by FCM.Lung histology confirmed pulmonary barotrauma and inflammation. This was associated with rises in CXCL-1, IL-6, TNF-α and albumin protein in the BALF. Significant acute increases in blood and lung neutrophils and CD43Lo/His48Hi (classical) monocytes/macrophages were detected. No significant changes were seen in blood or lung 'non-classical' monocyte, NK, B or T Cells. In the BALF, significant increases were seen in neutrophils, CD43Lo monocyte-macrophages and MCP-1. Significant increases in CD43Lo and Hi monocyte-macrophages were detected in the spleen at 6hr.This study reveals a robust and selective response of CD43Lo/His48Hi (classical) monocytes - in addition to neutrophils - in blood and lung tissue following PBLI. An increase in monocyte-macrophages was also observed in the spleen at 6hr. This profile of immune cells in the blood and BALF could present a new research tool for translational studies seeking to monitor, assess or attenuate the immune response in blast injured patients.Experimental laboratory study.WC- 300.