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A pulmonary contusion, also known as lung contusion, is a bruise of the lung, caused by chest trauma. As a result of damage to capillaries , blood and other fluids accumulate in the lung tissue. The excess fluid interferes with gas exchange , potentially leading to inadequate oxygen levels ( hypoxia ).
The pathophysiology of acute respiratory distress syndrome involves fluid accumulation in the lungs not explained by heart failure (noncardiogenic pulmonary edema). It is typically provoked by an acute injury to the lungs that results in flooding of the lungs' microscopic air sacs responsible for the exchange of gases such as oxygen and carbon dioxide with capillaries in the lungs. [1]
VALI is most common in people receiving mechanical ventilation for acute lung injury or acute respiratory distress syndrome (ALI/ARDS). [1] 24 percent of people mechanically ventilated will develop VALI for reasons other than ALI or ARDS. [1] The incidence is probably higher among people who already have ALI/ARDS, but estimates vary widely. [1]
Diffuse alveolar damage (DAD) is a histologic term used to describe specific changes that occur to the structure of the lungs during injury or disease.Most often DAD is described in association with the early stages of acute respiratory distress syndrome (). [1]
Cardiogenic pulmonary edema and ARDS are common causes of a fluid-filled lung. Diffuse alveolar hemorrhage is a rarer cause of diffuse GGO seen in some types of vasculitis, autoimmune conditions, and bleeding disorders. [6] Inflammation and fibrosis can also cause diffuse GGOs.
Flail chest is usually accompanied by a pulmonary contusion, a bruise of the lung tissue that can interfere with blood oxygenation. [5] Often, it is the contusion, not the flail segment, that is the main cause of respiratory problems in people with both injuries. [6] Surgery to fix the fractures appears to result in better outcomes. [7]
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. [1] Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). [1] For those who survive, a decreased quality of life is common. [4]
An injury that is potentially more serious than pulmonary contusion, pulmonary laceration involves disruption of the architecture of the lung, [2] while pulmonary contusion does not. [3] Pulmonary laceration is commonly caused by penetrating trauma but may also result from forces involved in blunt trauma such as shear stress.