- 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;
- Management: - 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?.
