[Lung contusion: relevance of initial injured pulmonary volume measurement by computed tomography].
OBJECTIVE
To evaluate computed tomography quantification of injured pulmonary volume after thoracic trauma and its relevance for severity grade of patients with lung contusion.


METHODS
Retrospective study in a major French Level I university trauma center.


METHODS
Clinical and biological data including oxygenation index (PaO2/FIO2) and therapeutics modalities during the first 5 days: positive end expiratory pressure (Peep) and nitric oxide (NO), were collected on 49 patients with lung contusion resulting from thoracic trauma. Injured pulmonary volume was evaluated on initial thoracic tomodensitometry by 2 senior radiologists. The correlation between oxygenation index, therapeutics modalities and initial injured pulmonary volume was assessed for signification.


RESULTS
Injured pulmonary volume larger than 37.75% of total lung volume is associated with both hypoxemia at the twenty-fourth hour (PaO2/FIO2 <300), and need for Peep >6 cm H2O and /or ongoing NO administration on day 5.


CONCLUSIONS
Injured parenchymal pulmonary volume evaluation on initial tomodensitometry seems to be an important indicator of lung contusion severity. Thoracic computed tomography provides additional prognostic information in the initial evaluation of thoracic trauma with parenchymal injury.
Christin
F
F
Département d'anesthésie-réanimation-Samu, hôpital Edouard-Herriot, place d'Arsonval, 69437 cedex 03, Lyon, France. Christin.Francoise@wanadoo.fr <Christin.Francoise@wanadoo.fr>
Meyer
N
N
Launoy
A
A
Roedlich
M N
MN
Diebolt
J R
JR
Veillon
F
F
Pottecher
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000150:complications; D008168:Lung / Q000000981:diagnostic imaging*; D055370:Lung Injury; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers
D009569:Nitric Oxide; D010100:Oxygen