الفهرس 
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Abstract
Lung contusions are typically the result of blunt trauma to the chest wall. Motor vehicle and motorcycle crashes are the most common causes of this injury pattern, but it can also be seen with blast trauma. Approximately 25–35% of blunt chest traumas involve injury to the lung itself. The lungs are the second most common organ injured in blast injuries.
After the initial blunt or blast thoracic trauma, the edematous phase is notable for worsening interstitial edema and infiltrates, occurring within the first 1–2 h after injury. The air spaces become inundated with blood, inflammatory markers, and tissue debris, as there is an increase in alveolar and capillary permeability along with a reduction in surfactant production.
Ultrasonography is now becoming an accurate method for detecting interstitial edema. Based on this statement, it is assumed that chest ultrasound may be able to find pulmonary contusions at an earlier stage than CXR, therefore reaching a higher sensitivity in the emergency room.
The usefulness of LUS relates to the fact that parenchymal diseases such as pneumonia, pulmonary edema, and interstitial lung disease cause the interlobular septa to widen due to fluid accumulation from increased hydrostatic pressure or capillary permeability. This widening of the septa with fluid allows the propagation of ultrasound waves producing a reverberation artifact referred to as “B-lines”.
In this study, we aimed to work to assess ability of POCUS in monitoring fluid resuscitation in chest trauma patients with lung contusion to avoid volume overload.
Here, we 100 patients with chest trauma associated with lung contusion. Mean age of the studied patients was 51.94 ± 17.69 (years) with male predominance. The mode of trauma was motor car accidents (54%), fall from height (36%) and blunt trauma (10%). A total of 27 (27%), 38 (38%) and 39 (39%) patients had head& neck trauma, abdomen trauma and fractures, respectively.
Out of them 80 (80%) patients were improved without manifestation of volume overload and pulmonary edema (improved group). Meanwhile, the other 20 (20%) patients showed manifestation of volume overload and pulmonary edema (non-improved group).
The main finding in the current study was that mean B-lines score among all patients was 24.16 ± 7.65 with significantly higher score among non-improved group (34.50 ± 6.24 vs. 21.58 ± 5.49). Based on volume overload severity; 12 (12%), 67 (67%) and 21 (21%) patients had mild, moderate and severe volume overload; respectively.
Majority (80%) of non-improved group had severe volume overload and majority (78.8%) of improved group had moderate volume overload. At cutoff point > 27; B-lines scoring has 90% sensitivity, 87.5% specificity with 88% overall accuracy in prediction of volume overload in patients with chest trauma with area under curve was 0.928.