Pulmonary Contusion

What is a pulmonary contusion?

A pulmonary contusion is a bruise on your lungs from a chest injury. It causes fluid and blood to collect around your lungs. Its symptoms can sometimes be vague, like coughing or wheezing, until the injury is severe.

A pulmonary contusion is a serious condition that can cause life-threatening complications. Healthcare providers will need to monitor you in a hospital’s intensive care unit (ICU).

What are the symptoms of a pulmonary contusion?

Symptoms of a pulmonary contusion include:

• Trouble breathing or shortness of breath.
• Coughing.
• Wheezing.
• Fast heart rate (tachycardia).
• Coughing up blood.
• Chest pain.
• Bruises on your chest.

Symptoms can appear right after an injury or several hours to days later. You might notice slight changes, like a cough or breathlessness, before your symptoms become serious.

What causes a pulmonary contusion?

Blunt force trauma (impact with something dull) or a penetrating injury (one that goes through your skin and deeper tissues) causes a pulmonary contusion. The most common cause is injury from a car accident. Other causes can be explosions and stab wounds. These injuries damage the blood vessels around your lungs, so blood and other fluids collect in your lung tissues.

Who’s most at risk?

Anyone who’s had an injury that impacts their chest is at risk for a pulmonary contusion. Children are at higher risk for serious complications.

What are the complications of a pulmonary contusion?

Pulmonary contusions can lead to serious complications, including:

• Pneumonia.
• Acute respiratory distress syndrome (ARDS).
• Hypoxia, a condition where not enough oxygen is getting to your tissues.
• Hypercapnia and respiratory acidosis, conditions where you have too much carbon dioxide in your blood.

How is a pulmonary contusion diagnosed?

Healthcare providers diagnose a pulmonary contusion by getting images of your lungs. Imaging methods they might use include:

• Chest X-rays.
• Thoracic (chest) ultrasound.
• CT scan (computd tomography scan).

How is a pulmonary contusion treated?

There’s no specific treatment for pulmonary contusion. Healthcare providers will monitor you in the hospital and work to keep your condition stable while you heal. Some medications and procedures they might use to prevent complications and keep you comfortable include:

• Oxygen therapy.
• Pain medications.
• Pulmonary hygiene.
• Fluid drainage.
• Surgery to repair damage.
• Mechanical ventilation.

Can pulmonary contusions be prevented?

The only way to prevent a contusion is to avoid injury to your chest. Always wear your seatbelt when you’re driving or riding in a vehicle.

How long does it take a pulmonary contusion to heal?

Pulmonary contusions take about a week to heal. Depending on the severity of your condition, you may need to stay in the hospital for longer. Some people need surgery to repair damage to their lungs or chest.

Up to 20% of people with a pulmonary contusion develop pneumonia. It’s important to practice good pulmonary hygiene, including coughing up mucous and deep breathing.

What are the long-term effects of pulmonary contusion?

People who’ve had a pulmonary contusion sometimes have reduced lung function for years after the contusion heals. This can make it hard to breathe. You might also have long-lasting scarring (fibrosis).

What’s the mortality rate of pulmonary contusion?

It’s hard to know the exact mortality rate from a pulmonary contusion. But studies estimate it to be between 14% and 40%.

When should I go to the ER?

Go to an emergency room right away if you’ve had an injury to your chest. Even if you feel fine, having a healthcare provider check you out is always best. Call 911 if you’re having any of these symptoms:

• Chest pain.
• Difficulty breathing.
• Bluish skin, lips or nails.
• Dizziness.

What questions should I ask my doctor?

It might be helpful to ask a healthcare provider:

• What are my treatment options?
• How do I take care of myself when I go home?
• What symptoms should I look out for when I go home?
• When should I follow up with you?

A note from Cleveland Clinic

A pulmonary contusion is a life-threatening medical condition. If you have a chest injury or have been in a car accident, you might feel fine but have injuries you can’t see. It’s always best to check with a healthcare provider, especially if you start having serious symptoms, like chest pain or trouble breathing. They can catch any issues early, when you have the best chance for recovery without serious complications. They’ll monitor you closely and keep your condition stable while you get better.