Lung contusion: inflammatory mechanisms and interaction with other injuries.
This article reviews current animal models and laboratory studies investigating the pathophysiology of lung contusion (LC), a common and severe condition in patients with blunt thoracic trauma. Emphasis is on studies elucidating cells, mediators, receptors, and processes important in the innate pulmonary inflammatory response that contribute to LC injury. Surfactant dysfunction in the pathogenesis of LC is also discussed, as is the potential role of epithelial cell or neutrophil apoptosis. Studies examining combination injuries where LC is exacerbated by secondary insults such as gastric aspiration in trauma patients are also noted. The need for continuing mechanism-based research to further clarify the pathophysiology of LC injury, and to define and test potential therapeutic interventions targeting specific aspects of inflammation or surfactant dysfunction to improve clinical outcomes in patients with LC, is also emphasized.
Raghavendran
Krishnan
K
Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109, USA. kraghave@umich.edu
Notter
Robert H
RH
Davidson
Bruce A
BA
Helinski
Jadwiga D
JD
Kunkel
Steven L
SL
Knight
Paul R
PR
D000818:Animals; D017209:Apoptosis; D003288:Contusions / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D004195:Disease Models, Animal; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D018836:Inflammation Mediators / Q000378:metabolism; D055370:Lung Injury / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D009504:Neutrophils / Q000378:metabolism / Q000473:pathology; D011014:Pneumonia / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011663:Pulmonary Surfactants / Q000378:metabolism; D053120:Respiratory Aspiration / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000628:therapy
D018836:Inflammation Mediators; D011663:Pulmonary Surfactants