Haemodynamic and metabolic consequences of lung contusion following blunt chest trauma.

Haemodynamic 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 oxygen via a mask (Group 1, 8 patients) or needed assisted ventilation (Group 2, 10 patients). Cardiac index rose 25% during the first five days and remained elevated for three to six weeks. Pulmonary vascular resistance (PVR) and intrapulmonary shunting were elevated on admission and showed peaks on the second and fifth days. After three weeks there was still a shunt fraction of 21%, while PVR had become normal. Bronchial infections, sepsis and hyper-coagulability occurred more frequently in the respirator-treated group. Hospitalization was in average more than three times longer for these patients. It is concluded that respirator treatment should be restricted to patients in urgent need of artificial ventilation. The haemodynamic and metabolic findings were well correlated to the delayed clinical recovery.