Pulmonary Contusion: An Update on Recent Advances in Clinical Management

Cohn, Stephen M.; DuBose, Joseph J.

doi:10.1007/s00268-010-0599-9

Cited by 176 publications

(154 citation statements)

References 181 publications

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“…10,37 Furthermore, extrapulmonary traumatic injury (eg, sinonasal or oropharyngeal cavities) can lead to aspiration of blood, which also gives the appearance of lung hemorrhage. 20,38 Interestingly, external injuries consistent with traumatic injury (eg, fractures) were detected in the majority of the bats diagnosed with pulmonary barotrauma.…”

Section: Discussionmentioning

confidence: 99%

A Forensic Investigation Into the Etiology of Bat Mortality at a Wind Farm: Barotrauma or Traumatic Injury?

et al. 2012

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Migrating bats have increased mortality near moving turbine blades at wind farms. The authors evaluated competing hypotheses of barotrauma and traumatic injury to determine the cause. They first examined the utility of lungs from salvaged bat carcasses for histopathologic diagnosis of barotrauma and studied laboratory mice as a model system. Postmortem time, environmental temperature, and freezing of carcasses all affected the development of vascular congestion, hemorrhage, and edema. These common tissue artifacts mimicked the diagnostic criteria of pulmonary barotrauma; therefore, lung tissues from salvaged bats should not be used for barotrauma diagnosis. The authors next compared wind farm (WF) bats to building collision (BC) bats collected near downtown Chicago buildings. WF bats had an increased incidence in fracture cases and specific bone fractures and had more external lacerations than BC bats. WF bats had additional features of traumatic injury, including diaphragmatic hernia, subcutaneous hemorrhage, and bone marrow emboli. In summary, 73% (190 of 262) of WF bats had lesions consistent with traumatic injury. The authors then examined for ruptured tympana, a sensitive marker of barotrauma in humans. BC bats had only 1 case (2%, 1 of 42), but this was attributed to concurrent cranial fractures, whereas WF bats had a 20% (16 of 81) incidence. When cases with concurrent traumatic injury were excluded, this yielded a small fraction (6%, 5 of 81) of WF bats with lesions possibly consistent with barotrauma etiology. Forensic pathology examination of the data strongly suggests that traumatic injury is the major cause of bat mortality at wind farms and, at best, barotrauma is a minor etiology.

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Section: Discussionmentioning

confidence: 99%

A Forensic Investigation Into the Etiology of Bat Mortality at a Wind Farm: Barotrauma or Traumatic Injury?

et al. 2012

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“…52,57,58 As an example, the pathologic evolution of pulmonary contusion (itself a risk factor for pneumonia) typically reaches peak pulmonary decompensation at ϳ72 h postinjury. 59 Another issue is that the results of VAE monitoring will differ depending on whether data are collected electronically or manually and particularly on the intensity of electronic data capture. 52 More importantly, retrospective studies suggest that VAP prevention bundles do not affect the incidence of VAE.…”

Section: Initial Studies On Ventilator-associated Event Surveillancementioning

confidence: 99%

The Vexing Problem of Ventilator-Associated Pneumonia: Observations on Pathophysiology, Public Policy, and Clinical Science

Kallet

2015

Respir Care

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SummaryVentilator-associated pneumonia (VAP) is an acquired infection related primarily to the consequences of prolonged endotracheal intubation. It is considered the most important infectious challenge in the critical care setting. Preventable complications of hospital care are considered an important source of wasted health-care costs believed to consume up to 47% of annual expenditures in the United States. Whether VAP is preventable has become a highly contentious debate since public reporting commenced a decade ago. This selective review focuses on specific aspects of this debate, including the inherent vagaries in the diagnosis of VAP and the marked disparities between VAP rates based on clinical diagnosis versus surveillance data. Also discussed is how this debate has impacted public policy, leading to the new paradigm of ventilator-associated events. The limited ability of artificial airways to prevent microaspiration and biofilm build-up, as well as non-modifiable conditions increasing the risk of VAP, is described in detail. In addition, the origins of the mistaken but widely embraced notion that zero VAP is a realistic achievement are examined.

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“…Some studies have also reported that up to 20% of patients with blunt chest trauma developed acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) (14,15). Also, airway obstruction, tension pneumothorax, and massive hemoth- orax are the immediate, life-threatening complications of chest trauma that require evaluation and treatment during primary survey (16).…”

Section: Introductionmentioning

confidence: 99%

“…Thoracic injuries cover the spectrum from trivial to lethal, and more than half of them are associated with head, abdomen, or extremity trauma (6,15). Therefore, proper evaluation of thoracic injury complications could prevent delayed treatment consequences and reduce mortality and morbidity rates (17,18).…”

Section: Introductionmentioning

confidence: 99%

Blunt Thoracic Injury Mortality and Clinical Presentation

Yadollahi¹,

Arabi²,

Mahmoudi³

et al. 2018

Trauma Mon

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Background: Blunt thoracic trauma is the third most common injury in poly-trauma patients following head and extremities injuries; this study aimed at investigating the prevalence of blunt chest trauma and its injury pattern, mechanism of injury, length of hospital stay, treatment period, and risk factors. Methods: In this cross-sectional study, 7,410 patients, who referred to Shahid Rajaee hospital, during years 2010 to 2014 were selected through census sampling. The participants' demographic data, mechanism of injury, type of thoracic injury, location of fracture, length of stay, and injury severity scores (ISS) were recorded.Results: Most patients were male (5498, 74.2%), 63.3% were 15 to 40 years old, and their mean age was 37.53 ± 0.21 years. The most commonly reported mechanism of injury was car accident (2,999, 40.5%) followed by falls (1,529,20.6%, and motorbike accidents (964, 13.1%). Head, neck and thorax injuries were most common comorbidities in thorax trauma patients. The mortality rate was 1.5%. Indeed, the patients, who had rib fracture (P = 0.01) (OR3.66, CI [1.36 -9.82]), and multiple injuries of thorax (P < 0.001) (OR 8.10,.73]), had a higher mortality risk. Conclusions:The risk of blunt thoracic injuries was higher among specific types of injuries. Additionally, patients with blunt chest trauma, who had the risk factors of mortality required preventative measures and careful management in order to prevent traumarelated deaths.Keywords: Thoracic Injuries, Trauma, Blunt BackgroundTrauma is the leading cause of death in patients under 40 years of age (1) and the fourth leading cause of death globally (2, 3). World health organization (WHO) announced in 2004 that trauma was the fourth main cause of death in Iran, and would turn into the third cause of death by 2020 (4).With regards to the prevalence of thoracic trauma compared to other types of trauma, it is an important cause of morbidity and mortality, which has led to approximately 25% of trauma-related deaths in the United States (5). Thoracic trauma is the third most frequent injury after head and extremities in patients with multiple trauma (5). In addition, approximately 0.06% of disability cases per year are caused by chest trauma (6). Blunt thoracic injuries are the third most common injury in poly-trauma patients following head and extremities trauma (7). Blunt chest trauma is directly responsible for 25% of all trauma deaths (8).Generally, more than 50% of blunt chest trauma cases occur in fatal accidents and a large number of them are caused by motor vehicle crashes (63% to 78%), followed by falls, blows from blunt objects, or explosive devices (10% to 17%) (9).Blunt traumatic injuries (BTI) represent a high incidence of morbidity and mortality worldwide (10). The most common mechanisms of blunt trauma are road traffic accidents (RTAs), falls, and being struck by heavy objects (11,12).Patients with blunt chest trauma may be at a significant risk of developing respiratory failure (13). Some studies have also reported that up to ...

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Pulmonary Contusion: An Update on Recent Advances in Clinical Management

Cited by 176 publications

References 181 publications

A Forensic Investigation Into the Etiology of Bat Mortality at a Wind Farm: Barotrauma or Traumatic Injury?

A Forensic Investigation Into the Etiology of Bat Mortality at a Wind Farm: Barotrauma or Traumatic Injury?

The Vexing Problem of Ventilator-Associated Pneumonia: Observations on Pathophysiology, Public Policy, and Clinical Science

Blunt Thoracic Injury Mortality and Clinical Presentation

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