Bruised Lungs: Learn About Pulmonary Contusions (2024)

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.

Bruised Lungs: Learn About Pulmonary Contusions (1)

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

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:

  • Chest pain
  • Hemoptysis (coughing up blood)
  • Severe shortness of breath

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.

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)
  • Acute respiratory distress syndrome (ARDS)
  • 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.

7 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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  2. Dogrul BN, Kiliccalan I, Asci ES, Peker SC. Blunt trauma related chest wall and pulmonary injuries: an overview.Chin J Traumatol. 2020;23(3):125-138. doi:10.1016/j.cjtee.2020.04.003

  3. MedlinePlus. Blue discoloration of the skin.

  4. Rendeki S, Molnár TF. Pulmonary contusion. J Thorac Dis. 2019;11:S141-S151. doi:10.21037/jtd.2018.11.53

  5. Zingg SW, et al. The association between pulmonary contusion severity and respiratory failure. Respiratory Care. 2022;67(9):1100-1108. doi:10.4187/respcare.09913

  6. Choudhary S, Pasrija D, Mendez MD. Pulmonary contusion. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2023. PMID: 32644340.

  7. Kaiser Permanente. Pulmonary contusion: care instructions.

Bruised Lungs: Learn About Pulmonary Contusions (2)

By Rachael Zimlich, BSN, RN
Zimlich is a critical care nurse who has been writing about health care and clinical developments for over 10 years.

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