Pulmonary contusion in children: diagnosis and management.

BACKGROUND

Pulmonary contusion (PC) is the most common injury identified in pediatric blunt chest trauma. The disagreement over management principles of children with PC may complicate care of these patients.

METHODS

We reviewed the literature and our institutional experience.

RESULTS

Pulmonary contusion is most often diagnosed by chest roentgenogram, with computed tomography of the chest reserved for more precise evaluation of the mediastinum and aorta. Hypoxemia and respiratory mechanical insufficiency are the most common causes of morbidity from early chest injury. Complications include pneumonia and the adult respiratory distress syndrome, which together may occur in up to one half of all cases.

CONCLUSIONS

Early diagnosis, maintaining euvolemia, and selective mechanical ventilation may help to limit morbidity. Management guidelines based on the available literature may improve the care of these patients.