Lung contusion: pathophysiology and management

  title={Lung contusion: pathophysiology and management},
  author={Yoram Klein and Stephen M. Cohn and Kenneth G. Proctor},
  journal={Current Opinion in Anaesthesiology},
&NA; Management of severe pulmonary contusion is a challenge for clinicians. The incidence of adult respiratory distress syndrome (5‐20%), pneumonia (5‐50%), and mortality (5‐10%) associated with traumatic lung injury has changed little in the past three decades. Therapeutic options are limited to basic supportive measures such as mechanical ventilation, positive end expiratory pressure, invasive cardiopulmonary monitoring, analgesics and aggressive pulmonary hygiene. Presently, no… 

Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course.

Clinically, patient's presents with hypoxiemia, hypercarbia and increase in laboured breathing, and patients are treated with supplemental oxygen and mechanical ventilation whenever indicated.

Pulmonary contusions after blunt chest trauma: clinical significance and evaluation of patient management

It is suggested that a pulmonary contusion seen on CT only has limited clinical significance and that the use of CT scans in diagnosing and follow-up of these patients should be re-evaluated.

The Prognostic Significance of Pulmonary Contusions on Initial Chest Radiographs in Blunt Trauma Patients

Amongst intubated blunt trauma patients with confirmed pulmonary contusions diagnosis, anInitial chest radiograph that reveals immediate pulmonary contusion is associated with higher mortality and ARDS compared with the absence of such findings, which suggests that the initial chest radiographs have prognostic significance in relation to pulmonary contulations due to blunt trauma.

Novel resuscitation strategy for pulmonary contusion after severe chest trauma.

Hextend reduced the volume for initial resuscitation, which may offer logistical advantages in prehospital field conditions or whenever there is limited medical resources or prolonged transport times; ATL-146e improved early cardiac performance without causing hypotension or bradycardia.

Pulmonary Contusion on Admission Chest X-ray is Associated with Coagulopathy and Mortality in Trauma Patients

Pulmonary Contusion present on admission CXR in trauma patients is associated with an increased prevalence of coagulopathy on admission and mortality, which increased with severity of pulmonary contusion in PC patients.

Severe thoracic trauma caused left pneumonectomy complicated by right traumatic wet lung, reversed by extracorporeal membrane oxygenation support—a case report

V-V ECMO and ultra-low VT MV helped this thoracic trauma patient survive the lung edema period and prevented ventilator associated pneumonia (VAP) and helped him make a recovery.

Treatment of Diffuse Pulmonary Hemorrhage with Factor VIIa

A case of the successful use of recombinant activated factor VII (NovoSeven™) in the treatment of life-threatening diffuse pulmonary hemorrhage secondary to an isolated blunt force thoracic injury without relevant traumatic coagulopathy is reported.

Predictive Factors of Ventilatory Support in Chest Trauma

The need for invasive ventilatory support in thoracic trauma is associated to the patient’s systemic severity, and non-invasive ventilation is a supportive treatment indicated in physiologically stable patients regardless of the severity ofThoracic injury.

Blunt Thoracic Injury Mortality and Clinical Presentation

The risk of blunt thoracic injuries was higher among specific types of injuries and patients with blunt chest trauma, who had the risk factors of mortality required preventative measures and careful management in order to prevent traumarelated deaths.



ARDS after pulmonary contusion: accurate measurement of contusion volume identifies high-risk patients.

Extent of contusion volumes measured using three-dimensional reconstruction allows identification of patients at high risk of pulmonary dysfunction as characterized by development of ARDS.

High-frequency Jet Ventilation in Life-threatening Bilateral Pulmonary Contusion

High-frequency jet ventilation can be a life-saving technique in severely hypoxemic patients with bilateral pulmonary contusion, and a series of severe trauma patients with life-threatening pulmonary contusions successfully treated with HFJV when the conventional mechanical ventilation approach failed to provide appropriate gas exchange.

Outcome of lung trauma.

An excellent outcome can be achieved managing penetrating injuries of the lung by an aggressive approach and urgent surgical intervention even when emergency room thoracotomy is essential.

Changes in contused lung volume and oxygenation in patients with pulmonary parenchymal injury after blunt chest trauma.

Degree of impaired oxygenation is related to the volume of the diffuse lesion that is recognized soon after injury, and there was no significant correlation after 1 week after injury.

Respiratory failure. Conventional and high-tech support.

Blunt Chest Trauma in the Elderly Patient: How Cardiopulmonary Disease Affects Outcome

It is concluded that elderly patients with multiple rib fractures and cardiopulmonary disease are at significant risk for complications that result in readmission to the hospital and intensive care unit and prolonged length of hospitalization.

Radiology of lung trauma.

  • W. De WeverJ. BogaertJ. Verschakelen
  • Medicine
    JBR-BTR : organe de la Societe royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie
  • 2000
Conventional chest film is the most important imaging technique for initial evaluation and follow-up of patients with trauma to the lungs, however, CT is more sensitive and specific to detect and identify pulmonary lesions.

Effects of a novel antioxidant during resuscitation from severe blunt chest trauma.

Previous work suggests that neutrophils (PMNs) and/or prostaglandins might mediate the progressive respiratory failure after severe pulmonary contusion. Since reactive oxygen metabolites are closely

Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making.

Radiographically determined injuries to the lung parenchyma have a closer association with adverse outcome than chest-wall injuries but are often not diagnosed until 24 hours after injury, so clinical decision making may be flawed if this information is used alone.

Pediatric thoracic trauma.

Thoracic injuries in children below 12 years of age are usually from motor vehicle accident related blunt trauma, and Pulmonary contusion and pneumothorax are the most common thorACic injuries.