Lung Contusion

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Dear Karim,

Anything new in treating flail chest with pulmonary contusion? Mechanical
ventilator (internal splinting), etc.?

Thanks.

Jose Luis J. Danguilan, MD
Manila, Philippines


On 1/29/09, Karim Brohi <karimbrohi at gmail.com> wrote:
>
> While I would agree with minimizing crystalloids and maintaining euvolaemia
> I don't think there's any evidence to support fluid restriction in these
> patients.  A normal enteral fluid requirement should be adequate.  No
> diuretics.
> Karim
>
>
> On 01/29/2009, KMATTOX at aol.com <KMATTOX at aol.com> wrote:
> >
> > You are correct.   Lasix is probably contraindicated in
> > pulmonary  contusion.
> >   We would use fluid RESTRICTION to even almost no  crystalloid fluid at
> > all.    AVOID ALBUMIN at all  cost.    ONE doctor, not a team of multiple
> > consultants writing  orders
> >
> > k
> >
> >
> >
> > In a message dated 1/28/2009 8:32:21 P.M. Central Standard Time,
> > errington at erringtonthompson.com writes:
> >
> > As a  rule we don't use Lasix in pulmonary contusions.  The goal in
> > caring  for patients with pulmonary contusions is
> > euvolemia.  Intubate  early
> > if necessary. Head of the bed should be elevated.  No  prophylactic
> > antibiotics.  Early tracheostomy.
> >
> > Guys, am I missing  anything?
> >
> >
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