Pulmonary Contusion
•Largest # of pts are those with
blunt trauma
•Most common chest injury in children
•Usually develops over 24 hours
•Can occur with or without laceration of
parenchyma
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Pulmonary Contusion - Surgery - Lecture Slides, Slides of General Surgery
This lecture covers a topic in Surgery. Keywords are given below: Pulmonary Contusion, Blunt Trauma, Common Chest Injury, Laceration of Parenchyma, Interstitial Spaces of Lung, Significant Inflammatory Reaction, Pulmonary Contusion Treatment
Typology: Slides
2011/2012
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Pulmonary Contusion
- Largest # of pts are those with
blunt trauma
- Most common chest injury in children
- Usually develops over 24 hours
- Can occur with or without laceration of
parenchyma
Pulmonary Contusion
Results from:
- Leakage of blood and fluid into interstitial spaces of lung
- Significant inflammatory reaction to blood
components in the lung
Pulmonary Contusion
- Complications
- Atelectasis
- Pneumonia
- ARDS
- Respiratory failure
Pulmonary Contusion
- Diagnosis
- Parenchymal
infiltrate seen in
CXR adjacent to
injured chest wall
Pulmonary Contusion
- Diagnosis
Lung gets stiffer causing dyspnea and increased RR
Blood gases worsen 2-3 days as edema increases
CXR changes may lag 12 - 48hrs behind
- May underestimate the true extent
CT - very sensitive – can allow quantifying
Pulmonary Contusion
- Treatment
MOSTLY supportive - usually resolve in 5-8 days
- O2 + observation in milder cases
- Pain control to allow :
- adequate ventilation and better management of secretions
- Fluid restriction
- Intubation + mechanical ventilation » if respiratory distress present
Myocardial contusion
- Physical bruising of the cardiac muscle
- Usually associated with fractures of the sternum
- Any severe anterior chest injury
Myocardial contusion
- Difficult to dx
• => HIGH LEVEL OF
SUSPICION
- ALL pts with pattern of injury must have an EKG
Myocardial contusion
- Treatment
- Monitor in ICU & treat dysrhythmias
- Serial enzymes
- Analgesia
Massive Hemothorax
- Pleural cavity hold 3 liters blood
- 200cc – 1L in chest cavity seen on CXR
- 90% from internal mammary or intercostals
- 10% from pulmonary vessels