Parenchymal Injuries

Injuries to lung parenchyma are common, but in the majority of cases supportive management is sufficient. In the setting of blunt trauma, primary concerns are acute or delayed respiratory compromise including pneumonia or adult respiratory distress syndrome (ARDS). In the setting of penetrating injury, the most common indication for surgery is active hemorrhage and, less commonly, significant air leak. If surgery is required, the primary goal is to preserve as much parenchyma as possible, which is associated with improved survival.