Lung contusions (LC) in children are frequent findings after road accidents. Possible residual lesions may potentially influence long-term lung development. Study on serial evaluation of pulmonary function in identical subjects has not published yet.
Forty four chidren injured at the age of 10.0±4.0 (ranged 2.3-17.5) yrs were diagnosed and treated for LC. These subjects were studied serially 2.0±1.8 (ranged 0.1-6.6) yrs and later again 8.4±3.3 (ranged 0.8-12.6) yrs after injury (when only 21 subject were accessible). The same protocol was used in both studies: static lung volumes by body plethysmography, lung elasticity using esophageal balloon technique and airway patency (by body plethysmography and flow-volume curves). 29/44 were ventilated by conventional CMV 13.9±14.0 (ranged 2-70) days, FiO2 0.50±0.2 (ranged 0.3-0.4). The following findings were detected: pneumo- or hemothorax (n=6), sepsis (n=18), ARDS (n=6) and/or ribs/clavicle fractures (n=14). No previous history of chronic lung disease was ascertained.
Normal lung size (both in 1st and 2nd study, respectively), i.e., TLC 97±12 and 102±12% predicted, N.S.) was found. Normal airway patency (PEF 99±21% vs 105±23% predicted, resp., P<0.04 as well as MEF25/TLC 92±32% vs 87±22% predicted, resp., N.S.) was also found over the years. No signs of hyperinflation were also found in both studies. Initial finding of stiffer lung normalized in the 2nd study: lung recoil at 100% TLC decreased from 123±30% to 119±31% predicted, resp., N.S.).
In conclusion, despite serious lung injury during childhood the next favourable lung development till early adolescence was confirmed.
Children who recovered after a lung contusion will not suffer from significant late pulmonary dysfunction.
Jan Sulc, None.