Pulmonary Contusion (Bruised Lung): Causes and Treatments
Severe complications may warrant care in the ICU
Medically reviewed by Reza Samad, MD
Pulmonary contusion (bruised lung) occurs as the result of serious blunt force trauma and can be a sign that you sustained a severe injury. Despite your lungs being protected by your rib cage, they can become bruised when met with significant force and typically result from high-impact injuries. Such injuries can be sustained in a car accident or a fall from a significant height.
This article explores pulmonary contusion causes, symptoms, and recovery timeline.
SDI Productions / Getty Images
Pulmonary Contusion Causes and Risk Factors
Like most of your organs, your lungs are surrounded by layers of connective tissue. Exactly how lung contusions develop is questionable, but these interior bruises are thought to result from damage to the air sacs (alveoli) in your lungs, which can disrupt your breathing.
Blunt force injuries are the cause most chest traumas. It's possible to develop a pulmonary contusion without a traumatic injury, but the most common causes of pulmonary contusions are:
Assaults
Explosions
Falls from a significant height
Motor vehicle accidents
Sports-related collisions
Read Next: Causes of Lung Pain and Treatment Options
Pulmonary Contusion Symptoms
The symptoms that can appear early on with bruised lungs can mimic those of other chest injuries. If you develop a pulmonary contusion, you may experience symptoms like:
Hemoptysis (coughing up blood)
It's possible to have no symptoms with a pulmonary contusion. It can take between 24 and 48 hours after the initial injury for symptoms to develop. Later signs of a severe pulmonary contusion or complications caused by the injury include:
Cyanosis (bluish skin, lips, or nail beds, which can indicate a lack of oxygen)
Decreased breath sounds
Decreased oxygen levels
Distention (swelling) of the jugular vein in the neck
Flailing motions in the chest (chest movements that indicate multiple broken ribs)
Increased heart rate
Increased respiratory rate
Nasal flaring
Retractions in the chest wall when you breathe
Pulmonary contusions can't be seen with the naked eye and are often only diagnosed once severe complications occur.
Related: The Different Types of Chest Trauma and Injuries
Pulmonary Contusion on X-Ray
If you or a loved one sustains a traumatic chest injury, the healthcare team will first evaluate symptoms and vital measurements like heart rate, blood pressure, and oxygen saturation. Once your condition is stabilized, they will do imaging studies to investigate the full extent of your injuries.
A chest X-ray and ultrasound can provide enough information for a diagnosis. However, a computed tomography (CT) scan is more comprehensive, and most providers prefer this option when available.
On an X-ray, a bruised lung can appear as an area of patchy shadowing or consolidation, but an X-ray may not detect early damage.
A CT scan can provide more detailed images of the lung and surrounding areas. This is important since blunt chest injuries can impact more than just the lungs. CT imaging allows healthcare providers to examine surrounding spaces and vessels in the chest cavity for related damage.
Short- and Long-Term Pulmonary Contusion Complications
There are short-term and long-term problems that can arise from a pulmonary contusion.
Immediately after the injury, a pulmonary contusion can lead to complications such as:
A collapsed lung (pneumothorax)
Blood leaking around the lung (hemothorax)
Respiratory distress requiring intubation and mechanical ventilation
Pulmonary contusions are serious injuries that usually require prolonged hospitalization and treatment. The long-term consequences of a pulmonary contusion will depend heavily on the extent of the initial damage, what complications developed, and how quickly or effectively these problems were treated.
When complications like ARDS and pneumonia develop from a pulmonary contusion, long-term respiratory failure is a genuine threat. Long-term respiratory failure carries a mortality rate of between 10% and 25%.
More severe pulmonary contusions are also associated with more extensive treatments like prolonged stays in a critical care unit and extended use of mechanical ventilation.
Treatment and Management
Traumatic injuries are often complex, which could contribute to a missed or late diagnosis of pulmonary contusion. Pulmonary contusions can heal without complications in a week or less when recognized and treated appropriately.
Healthcare providers monitor pulmonary contusions closely to identify complications and prevent respiratory failure. Additional management strategies include:
Intravenous fluids to treat hypovolemia (fluid loss)
Pain management to control labored breathing
Sitting in a reclining position
Treating fluid overload with diuretic medications
Using supplemental oxygenation through noninvasive or invasive methods
With complications, invasive oxygen therapy like intubation and mechanical ventilation are possible options. If complications progress to ARDS, prone (lying on your stomach) positioning and other intensive treatments may follow.
Overall, treatment for pulmonary contusion isn't always predictable. Early detection, diagnosis, and treatment are vital in preventing respiratory failure, but complications are common.
Pulmonary Contusion Recovery and Rehabilitation
Supportive care like oxygen therapy and good respiratory hygiene can help reduce the likelihood of severe complications.
The goals of recovery and rehabilitation for a pulmonary contusion are to ensure the following:
You are consistently getting enough oxygen.
You get rid of injury-associated pain.
Your airways remain clear.
Healthcare providers advise those recovering from a pulmonary contusion to cough and take regular deep breaths to keep their lungs clear and support recovery.
Prevention
Prevention measures for pulmonary contusions are standard safety measures aimed at avoiding traumatic injuries. These include things like:
Avoiding high-risk activities
Following workplace safety rules
Preventing falls
Wearing protective gear during contact sports
Wearing seat belts when driving or riding in a vehicle
These steps can help prevent traumatic injuries, but not entirely. It's important to seek immediate medical care in the event of chest trauma to quickly detect and treat bruised or damaged lungs.
Summary
A pulmonary contusion is a common traumatic chest injury and one that can cause significant short- and long-term complications. Standard safety measures to prevent traumatic injury, like wearing a seat belt, can help you avoid these injuries. Treatment when these injuries do happen often requires hospitalization and sometimes prolonged intensive care.
If you've had an injury to the chest, see a healthcare provider for a full assessment to prevent a missed diagnosis and severe consequences.
Read the original article on Verywell Health.
