Pulmonary contusion history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

History and Symptoms

Presentation may be subtle; people with mild contusion may have no symptoms at all.[1] However, a pulmonary contusion is frequently associated with signs (objective indications) and symptoms (subjective states), including those indicative of the lung injury itself and of accompanying injuries. Because gas exchange is impaired, signs of low blood oxygen saturation, such as low concentrations of oxygen in arterial blood gas and cyanosis (bluish color of the skin and mucous membranes) are commonly associated. Dyspnea (painful breathing or difficulty breathing) is commonly seen, and tolerance for exercise may be lowered. Rapid breathing and a rapid heart rate are other signs.[2][3] With more severe contusions, breath sounds heard through a stethoscope may be decreased, or rales (an abnormal crackling sound in the chest accompanying breathing) may be present. People with severe contusions may have bronchorrhea (the production of watery sputum).[4] Wheezing and coughing are other signs.[5] Coughing up blood or bloody sputum is present in up to half of cases.[5] Cardiac output (the volume of blood pumped by the heart) may be reduced,[4] and hypotension (low blood pressure) is frequently present. The area of the chest wall near the contusion may be tender or painful due to associated chest wall injury.

Signs and symptoms take time to develop, and as many as half of cases are asymptomatic at the initial presentation.[1] The more severe the injury, the more quickly symptoms become apparent. In severe cases, they may occur by three or four hours after the trauma.[4] Hypoxemia (low oxygen concentration in the arterial blood) typically becomes progressively worse over 24–48 hours after injury. In general, pulmonary contusion tends to worsen slowly over a few days, but it may also cause rapid deterioration.

References

  1. 1.0 1.1 Costantino M, Gosselin MV, Primack SL (2006). "The ABC's of thoracic trauma imaging". Seminars in Roentgenology. 41 (3): 209–225. doi:10.1053/j.ro.2006.05.005. PMID 16849051. Unknown parameter |month= ignored (help)
  2. Mick NW, Peters JR, Egan D, Nadel ES, Walls R, Silvers S (2006). "Chest trauma". Blueprints Emergency Medicine. Second edition. Philadelphia, PA: Lippincott Williams & Wilkins. p. 76. ISBN 1-4051-0461-9.
  3. Coyer F, Ramsbotham J (2004). "Respiratory health breakdown". In Chang E, Daly J, Eliott D. Pathophysiology Applied to Nursing. Marrickville, NSW: Mosby Australia. pp. 154&ndash, 155. ISBN 0-7295-3743-9.
  4. 4.0 4.1 4.2 Gavelli G, Canini R, Bertaccini P, Battista G, Bnà C, Fattori R (2002). "Traumatic injuries: Imaging of thoracic injuries". European Radiology. 12 (6): 1273–1294. doi:10.1007/s00330-002-1439-6. PMID 12042932. Unknown parameter |month= ignored (help)
  5. 5.0 5.1 Yamamoto L, Schroeder C, Morley D, Beliveau C (2005). "Thoracic trauma: The deadly dozen". Critical Care Nursing Quarterly. 28 (1): 22–40. PMID 15732422.



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