Pulmonary contusion causes long-term respiratory dysfunction with decreased functional residual capacity

J Trauma. 1991 Sep;31(9):1203-8; discussion 1208-10. doi: 10.1097/00005373-199109000-00002.


To elucidate the mechanism of persistent dyspnea after blunt chest trauma, we prospectively studied the pulmonary function of 18 patients with blunt chest trauma for 6 months. Nine of the patients had flail chest and 12 had pulmonary contusion (PC). Pulmonary function was evaluated using spirometry, arterial blood gas analysis, chest x-ray studies and CT scans. Functional residual capacity (FRC) remained significantly reduced throughout the 6 months in patients with PC. Such patients experienced a fall in Pao2 when changed from a sitting position to a supine position and they had fibrous changes in the contused lung as demonstrated by CT scans at 6 months after injury. These findings were supported in an additional study of another 20 patients who had suffered PC 1 to 4 years previously. This study demonstrated that pulmonary function recovered within 6 months in patients without PC even with a residual deformity of the thoracic wall caused by flail chest, while patients with PC had decreased FRC and a fall in Pao2 when moved to the supine position even several years after injury. This might be related to the persistent dyspnea seen after blunt chest trauma.

MeSH terms

  • Adult
  • Dyspnea / etiology*
  • Flail Chest / etiology*
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Middle Aged
  • Posture
  • Respiratory Function Tests
  • Spirometry
  • Thoracic Injuries / complications*
  • Thoracic Injuries / physiopathology
  • Time Factors