- See: Cardiac Contussion:
- primary complication is comprimised oxygenation;
- due to intersitial hemorrhage with alveolar collapse and alveolar flooding
- shunting, results in hypoxia that is relatively refractory to enhanced inspiratory oxygen concentration;
- pulmonary contusions are usually quite localized;
- PEEP and continuous positive airway pressure
- over-agressive diuresis or extreme hypovolemia can decrease cardiac output and exacerbate hypoxemia already present due to intrapulmonary shunting associated with pulmonary contusssion;
- the decision not to intubate should be based on:
- the overall stability of the of the patient
- adequacy of oxygenation (pO2 > 60 mm on 50% O2) - respirations of > 24 / min
- spontaneous tidal volume greater than 5 ml/kg
- vital capacity > 10 ml/kg
- pulmonary mechanics
Primary intramedullary femur fixation in multiple trauma patients with associated lung contusion--a cause of posttraumatic ARDS?
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Monday, December 19, 2011 4:43 pm