Pulmonary Contusions

Describe the pathology associated with pulmonary contusions.

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The 3 components of a pulmonary contusion include edema, hemorrhage, and atelectasis.

 

Discuss the use of oxygen supplementation and diuretics in the treatment of pulmonary contusions.

Discuss the controversial use of steroids in the treatment of pulmonary contusions.

Corticosteroids have not been documented to be beneficial in the management of patients with pulmonary contusions. In fact, by contributing to the immunosuppression in these patients, corticosteroids may predispose the patient to the development of bacterial pneumonia.

 

 

Describe the concerns with regards to the use of fluid therapy in patients with pulmonary contusions.

Progression of pulmonary contusions is often related to aggressive fluid volume administration during resuscitation of trauma patients. Overly aggressive crystalloid administration may result in pulmonary edema complicated the pulmonary contusions. Cautious crystalloid administration during resuscitation is necessary to support the cardiovascular system, recognizing that pulmonary contusions could be made worse by overzealous fluid administration. Colloid administration may decrease the amount of lung water that accumulates during resuscitation.  However, leakage of colloids may also increase edema formation.

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