Pulmonary Contusion Causes Long-Term Respiratory Dysfunction with Decreased Functional Residual Capacity

Kishikawa, Masanobu; Yoshioka, Toshitsugu; Shimazu, Toshihiro; Sugimoto, Hideyoshi; Sugimoto, Tadafumi

doi:10.1097/00005373-199109000-00002

Cited by 74 publications

(14 citation statements)

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“…5 Injuries to the chest wall with significant residual deformity do not result in long-term respiratory dysfunction unless there is an associated pulmonary contusion. 6 Therefore, surgical stabilization is generally not performed for rib fractures and has not been proven to be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Reoperative Surgical Stabilization of a Painful Nonunited Rib Fracture Using Bone Grafting and a Metal Plate

Cho

Kim

Kang

et al. 2009

Journal of Orthopaedic Trauma

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We report a case of a nonunited sixth rib in a patient with multiple rib fractures who underwent internal fixation using a wire and Judet strut 3 times. During the following 3 years, the patient continued to complain of pain and instability. At surgery, a pseudarthrosis between the ends of the sixth rib was excised. A longitudinal gutter crossing the fracture site was fashioned and splinted with an inlay block of cancellous bone grafted from the iliac crest; stabilization was accomplished with a reconstruction plate and screws. The following 2 years of follow-up demonstrated no instability or pain.

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Section: Discussionmentioning

confidence: 99%

Reoperative Surgical Stabilization of a Painful Nonunited Rib Fracture Using Bone Grafting and a Metal Plate

Cho

Kim

Kang

et al. 2009

Journal of Orthopaedic Trauma

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“…Pulmonary contusion (PC) is a common injury following motor vehicle crashes (MVCs) and blunt chest trauma (Shorr et al 1987) with potentially long-term respiratory deficiencies following injury (Kishikawa et al 1991). Previous NASS studies have shown that PC accounts for over 35% of Abbreviated Injury Scale 3+ chest injuries (Stitzel et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Finite Element Model Prediction of Pulmonary Contusion in Vehicle-to-Vehicle Simulations of Real-World Crashes

Danelson

Stitzel

2015

Traffic Injury Prevention

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“…These clinically manifest as hypoxia, hypercarbia, and an increased work of breathing (Cohn 1997;Kishikawa et al 1991).…”

Section: Introductionmentioning

confidence: 99%

Finite element–based injury metrics for pulmonary contusion via concurrent model optimization

Gayzik

Hoth

Stitzel

2010

Biomech Model Mechanobiol

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This study explores the relationship between impact severity and resulting pulmonary contusion (PC) for four impact conditions using a rat model of the injury. The force-deflection response from a Finite Element (FE) model of the lung was simultaneously matched to experimental data from distinct impacts via a genetic algorithm optimization. Sprague-Dawley rats underwent right-side thoracotomy prior to impact. Insults were applied directly to the lung via an instrumented piston. Five cohorts were tested: a sham group and four groups experiencing lung insults of varying degrees of severity. The values for impact velocity (V) and penetration depth (D) of the cohorts were Group 1, (V = 6.0 m · s(-1), D = 5.0 mm), Group 2, (V = 1.5 m · s(-1),D = 5.0 mm), Group 3, (V = 6 m · s(-1), D = 2.0 mm), and Group 4, (V = 1.5 m · s(-1), D = 2.0 mm). CT scans were acquired at 24 h, 48 h, and 1 week post-insult. Contusion volume was determined through segmentation. FE-based injury metrics for PC were determined at 24 h and 1 week post-impact, based on the observed volume of contusion and first principal strain. At 24 h post-impact, the volume of high radiopacity lung (HRL) was greatest for the severe impact group (mean HRL = 9.21 ± 4.89) and was significantly greater than all other cohorts but Group 3. The concurrent optimization matched simulated and observed impact energy within one standard deviation for Group 1 (energy = 3.88 ± 0.883 mJ, observed vs. 4.47 mJ, simulated) and Group 2 (energy = 1.46 ± 0.403 mJ, observed vs. 1.50 mJ, simulated) impacts. Statistically significant relationships between HRL and impact energy are presented. The FEA-based injury metrics at 24 h post-contusion are ε(max) · ε(max) exceeding 94.5 s(-1), ε (max) exceeding 0.284 and ε(max) exceeding 470 s(-1). Thresholds for injury to the lung still present at 1 week post-impact were also determined. They are ε(max) · ε(max) exceeding 149 s(-1), ε (max) exceeding 0.343 and ε(max) exceeding 573 s(-1). A mesh sensitivity study found that thresholds based on strain rate were more sensitive to changes to mesh density than the threshold based on strain only.

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Pulmonary Contusion Causes Long-Term Respiratory Dysfunction with Decreased Functional Residual Capacity

Cited by 74 publications

References 0 publications

Reoperative Surgical Stabilization of a Painful Nonunited Rib Fracture Using Bone Grafting and a Metal Plate

Reoperative Surgical Stabilization of a Painful Nonunited Rib Fracture Using Bone Grafting and a Metal Plate

Finite Element Model Prediction of Pulmonary Contusion in Vehicle-to-Vehicle Simulations of Real-World Crashes

Finite element–based injury metrics for pulmonary contusion via concurrent model optimization

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