Pulmonary contusion in children: Diagnosis and management

Background. Pulmonary contusion (PC) is the most common injury identified i n 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 evaluatio n of the mediastinum and aorta. Hypoxemia and respiratory mechanical insuff iciency are the most common causes of morbidity from early chest injury Com plications include pneumonia and the adult respiratory distress syndrome, w hich together may occur in up to one half of all cases. Conclusions. Early diagnosis, maintaining euvolemia, and selective mechanic al ventilation may help to limit morbidity. Management guidelines based on the available literature may improve the care of these patients.