Contusion of the lung in childhood.

The authors evaluated in a retrospective study a group of 45 patients with contusion of the lungs (age 1 to 15 years) who were treated at the Faculty Hospital in Motol in 1989-1993. In 38 children contusion of the lungs was part of multiple injuries with signs of failure of vital functions. These children were admitted after the injury to the in-patient department of the Anaesthesiological and Resuscitation Clinic. Seven children without alterations of vital functions were treated at the Department of Paediatric Surgery. The diagnosis was based on the case-history, clinical examination, X-ray examination and laboratory signs of lung injuries. An isolated pneumothorax was found in 17.8% of the injured children, haemothorax in 8.9% and in 24.5% pneumothorax and haemothorax. Severe craniocerebral injuries were diagnosed in 71% of patients, 37.8% children had concomitant injuries of the abdominal organs and retroperitoneum and 42% had fractures of the long bones. 46.6% of the children had rib fractures. The condition of 35 injured children called for endotracheal intubation (on average for 17 days) and artificial ventilation (on average for 14.4 days). 98% of the injured children were given antibiotics, in 84% steroids were administered, in 18 of the injured children (40%) drainage of the thoracic cavity was essential. Six patients (13.3%) drainage of the thoracic cavity was essential. Six patients (13.3%) died--the cause of death were severe injuries of the CNS.