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Pulmonary Contusion

Pulmonary Contusion is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Transfer of kinetic energy to the lung, causing direct damage to the lung parenchyma, resulting in both hemorrhage and edema in the absence of a pulmonary laceration
  • Mortality rate is 10–25%.
  • Independent risk factor for:
    • Acute respiratory distress syndrome
    • Pneumonia
    • Long-term respiratory dysfunction

Pathophysiology

  • Development of pulmonary contusion:
    • Takes place in 2 stages:
      • 1st stage, which is related to the direct injury, results in disruption of the alveolocapillary membrane, which leads to extravasation of blood into the interstitial and alveolar space.
      • 2nd stage is related to the indirect worsening of the injury as a result of measures that occur during the resuscitation of the patient, in particular, administration of IV fluids.
  • Leads to:
    • Increased intrapulmonary shunting
    • Increased resistance to airflow
    • Decreased lung compliance
    • Increased respiratory work
    • Hypoxemia and acidosis
    • Respiratory failure

Etiology

  • Blunt or penetrating thoracic trauma
  • Sudden deceleration–compression
  • Fall from height
  • Motor vehicle accident
  • Assault
  • Missile

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Citation

Rosen, Peter, et al., editors. "Pulmonary Contusion." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307094/all/Pulmonary_Contusion.
Pulmonary Contusion. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307094/all/Pulmonary_Contusion. Accessed April 23, 2019.
Pulmonary Contusion. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307094/all/Pulmonary_Contusion
Pulmonary Contusion [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307094/all/Pulmonary_Contusion.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pulmonary Contusion ID - 307094 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307094/all/Pulmonary_Contusion PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -