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Indian Journal of Critical Care Medicine
Medknow Publications on behalf of the Indian Society of Critical Care Medicine
ISSN: 0972-5229
EISSN: 1998-359x
Vol. 8, No. 2, 2004, pp. 73-77
Bioline Code: cm04015
Full paper language: English
Document type: Research Article
Document available free of charge

Indian Journal of Critical Care Medicine, Vol. 8, No. 2, 2004, pp. 73-77

 en Outcome in patients with blunt chest trauma and pulmonary contusions
Vignesh T, Arun Kumar AS, Kamat V

Abstract

ABSTRACT: Severe pulmonary contusions occur in blunt chest trauma, especially with high velocity injuries. Pulmonary contusions following trauma may result in significant hypoxemia and decreased compliance which may progress over several days. Extensive contusions may result in respiratory difficulty or progress to adult respiratory distress syndrome, which increases mortality. We decided to review the cases of polytrauma with associated pulmonary contusions to determine the factors which influence outcome.
MATERIALS AND METHODS: A retrospective chart review of all cases of trauma with pulmonary contusions on X-ray or CT scan. The cases were examined for age, type of injuries, admission APACHE II, SAPS II and SOFA scores, PaO2/FiO2 ratio, presence or absence of rib fractures, average positive fluid balance, average sedation dose, pulmonary haemorrhage, ventilator days, ICU days and hospital outcome.
RESULTS: There were 18 cases of pulmonary contusions. All had associated injuries. 6 patients died, 4 in the ICU and 2 patients died 1 week after transfer to a high dependency unit, one due to sepsis and the other due to massive haemothorax. There was a significant difference in PaO2/FiO2 ratio at admission and throughout the ICU course, fluid balance and sedation dose, but not in ventilator days and ICU days between survivors and nonsurvivors. The incidence, frequency and amount of pulmonary haemorrhage were higher in the nonsurvivors.
CONCLUSIONS: Close attention to improving gas exchange, and early management of hemoptysis might improve outcome in pulmonary contusions

Keywords
Chest trauma, pulmonary contusion, fluid balance, hemoptysis, rib fractures.

 
© Copyright 2004 Indian Journal of Critical Care Medicine.
Alternative site location: http://www.ijccm.org/

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