title: [Significance of lung contusion in mortality following polytrauma. Possibilities for therapeutic influence].
abstract: Multiple trauma is often associated with blunt thoracic injuries. Especially lung contusion can result in respiratory insufficiency and therefore a higher mortality rate. In our prospective study comparing 8 multiple trauma patients with and without associated lung contusion, we found that respiratory function was already significantly disturbed (decrease of paO2/FiO2 and increase of AaDO2, a rise in extravascular lung water (EVLW) both early after trauma and also with a second peak following the 4th day. This group (LK) developed significantly more cases of respiratory distress (ARDS). The disturbance of respiratory function seen initially was interpreted as a consequence of the direct mechanical impact, leading to the formation of interstitial fluid and hematoma. The frequent development of ARDS in the LK-group probably results from a pronounced activation of cellular and humoral mechanisms and therefore an enforced injury of the pulmonary capillary bed. A significant increase of pulmonary infections or the development of sepsis was not seen in the LK-group and is probably not responsible for the higher ARDS-rate in this group.
authors.affiliation: Unfallchirurgische Klinik, Medizinischen Hochschule Hannover.
authors.forename: G
authors.initials: G
authors.lastname: Regel
authors.forename: J A
authors.initials: JA
authors.lastname: Sturm
authors.forename: H P
authors.initials: HP
authors.lastname: Friedl
authors.forename: M
authors.initials: M
authors.lastname: Nerlich
authors.forename: U
authors.initials: U
authors.lastname: Bosch
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003288:Contusions / Q000401:mortality / Q000628:therapy*; D006801:Humans; D055370:Lung Injury; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors
vernacular_title: Die Bedeutung der Lungenkontusion für die Letalität nach Polytrauma. Möglichkeiten der therapeutischen Beeinflussung.