Lung Contusion

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How 'bout repair of the fractures?  Looks like this "antiquated" procedure is coming back into use - with initial results appearing to be impressive.  Anecdotal but impressive.  No LARGE studies to date, to my knowledge and this is why we are looking to put together a multicenter PRT to look at this very issue.

Any takers?

Ron

Ronald I. Gross, MD, FACS
Chief of Trauma & Emergency Surgery Services
Baystate Medical Center
759 Chestnut Street
Springfield, MA  01199
413-794-4022  phone
413-794-0142  fax
ronald.gross at baystatehealth.org
-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Jose Luis Danguilan
Sent: Thursday, January 29, 2009 6:19 PM
To: Trauma &amp, Critical Care mailing list
Subject: Re: Lung Contusion

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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