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Pulmonary contusion in the pediatric population
Miller Carlton Hamrick1, Ryan Donsworth Duhn, David Edward Carney
1Memorial Health University Medical Center, Georgia Ear Institute, Savannah 31404, USA. mchamrick@gmail.com
The American Surgeon
|August 12, 2010
Summary
Pediatric pulmonary contusion rarely leads to severe outcomes like respiratory failure or pneumonia in children. Unlike adults, children with lung contusions generally do not require invasive ventilation.
Area of Science:
- Pediatric Trauma Surgery
- Pulmonary Critical Care
Background:
- Pulmonary contusion is a known risk factor for respiratory failure in adults.
- Adult studies indicate a higher risk of morbidity when contusion exceeds 20% of lung volume.
Purpose of the Study:
- To investigate if pediatric pulmonary contusion carries similar morbidity risks as in adults.
- To compare outcomes of pediatric pulmonary contusion with established adult data.
Main Methods:
- Retrospective review of trauma patients aged 3-18 years from January 2005 to May 2007.
- CT scans assessed for pulmonary contusion volume (percentage of total lung volume).
- Exclusion of patients with confounding respiratory failure causes; outcomes recorded: invasive ventilation, pneumonia, oxygenation issues.
Main Results:
- Twenty-six pediatric patients met study criteria (mean age 13.35 years, mean Injury Severity Score 24).
- Mean pulmonary contusion volume was 19.81% of total lung volume.
- No patients required intubation or invasive airway management.
Conclusions:
- Pediatric pulmonary contusion appears to have significantly lower morbidity compared to adults.
- Invasive airway management is rarely necessary for pediatric patients with pulmonary contusion.
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