Haemodynamic and Metabolic Consequences of Lung Contusion Following Blunt Chest Trauma

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Abstract
Hemodynamic and metabolic pulmonary functional data were recorded in 18 patients suffering from lung contusion following blunt chest trauma. Similar qualitative results were obtained whether the patients were given O2 via a mask (Group 1, 8 patients) or needed assisted ventilation (Group 2, 10 patients). Cardiac index rose 25% during the 1st 5 days and remained elevated for 3-6 wk. Pulmonary vascular resistance (PVR) and intrapulmonary shunting were elevated on admission and showed peaks on the 2nd and 5th days. After 3 wk there was still a shunt fraction of 21%, while PVR had become normal. Bronchial infections, sepsis and hypercoagulability occurred more frequently in the respirator-treated group. Hospitalization was in average more than 3 times longer for these patients. Respirator treatment apparently should be restricted to patients in urgent need of artificial ventilation. The hemodynamic and metabolic findings were well correlated to the delayed clinical recovery.