Physiologic effects of fluid therapy after pulmonary contusion*

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Summary

The physiologic effects of fluid infusions given after pulmonary contusion were studied. Rapid infusion of blood, saline, or both produced an impulsive increase in pulmonary blood flow and pressure, particularly in the normal lung. A fall in normal lung resistance allows the pressure to reach the capillaries, resulting in leakage of blood and fluid into the normal lung (congestive atelectasis). Animals given rapid infusions suffered a shunt (Q̇s/Qt) fraction larger than that of contused lung blood flow and more severe hypoxemia than did the controls. Hypotension followed by blood and saline administration did not alter lung function compared with saline infusion alone.

It was suggested that some of the progression of pulmonary contusion as seen clinically and radiologically is due to damage in the normal lung. Monitoring of the pulmonary artery pressure during fluid administration after pulmonary contusion may be helpful in preventing further lung damage.

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*

Presented at the Twenty-Fifth Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, May 7–10, 1973.

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