Lung Contusion

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Nothing earth-shattering to my knowledge.  One of the most interesting areas
has always been how you ventilate a patient with severe unilateral pulmonary
contusions - ie. a very compliant normal lung and a very non-compliant
contused lung.  And how you protect the good lung from ARDS induced by
bronchial blood etc.  I think we're pretty poor at managing this sort of
injury in general.K

2009/1/29 Jose Luis Danguilan <jdanguilan at gmail.com>

> 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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