Effect of lung contusion on pulmonary hemodynamics.

Our purpose was to examine changes in pulmonary hemodynamics for patients with pulmonary contusion. Pulmonary vascular resistance index (PVRI) and shunt fraction were calculated from standard measurements in 25 traumatized patients. The percent of lung volume injured, measured as air-space filling disease (ASF), was quantitated from computed tomograms using a previously described technique.

Highlights of the history of nonpenetrating chest trauma.

The basic principles of the pathology, physiology, diagnosis, and management of nonpenetrating chest trauma evolved to a significant degree before World War II. The advances in the past 40 years include more frequent use of endotracheal intubation, improved ventilatory assistance, better control of blood volume, antibiotics, the clinical application of blood-gas studies, diagnostic imaging, and specialized nursing and monitoring in intensive care units. Thus, the improvement in survival is not primarily attributable to operative measures but rather to enhanced supportive measures.