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Effects of Experimental Pulmonary Contusion on Respiratory Exchange and Lung Mechanics

Robert T. Nichols, MD; Henry J. Pearce, MD; Lazar J. Greenfield, MD
Arch Surg. 1968;96(5):723-730. doi:10.1001/archsurg.1968.01330230031005.
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CURRENT interest in chest injuries stems from both the casualties of the Southeast Asia conflict and the increasing numbers of survivors of major traffic accidents. Twenty-five percent of the 53,000 deaths from automobile accidents in 1965 were secondary to chest injuries, and in one fourth of these, pulmonary contusion played a major role. Pulmonary contusion alone carries an early mortality as high as 38%.1

Whether the term pulmonary contusion, "traumatic wet lung," or "blast injury to the lung" is used the clinical picture is essentially the same. Even with evidence of significant blunt trauma to the chest, patients often complain only of other injuries, and mild hemoptysis may be the only sign of lung contusion. Early radiographs of the chest are often normal. However, signs of increasing respiratory insufficiency, hypoxia, and pneumonitis develop characteristically within 24 to 36 hours. Blood gas analyses show progressive arterial oxygen desaturation and often


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