Comparative Study between Usage of Arterial Blood Gases versus Calculated Pulmonary Contusion Volume in Estimating Prognosis and Potential Complications of Pulmonary Contusion after Blunt Chest Trauma

Background: Pulmonary contusion (PC) is a frequent and potentially fatal complication associated with blunt thoracic trauma.
Aim of the work: The goal of this research was to evaluate a comparative analysis of the prognostic value of ABG parameters versus CT-calculated PC volume in predicting complications (pneumonia & ARDS) following blunt chest trauma.
Patients and Methods: A prospective comparative study was executed on 50 participants with blunt chest trauma. All participants underwent ABG analysis and chest CT to assess PC volume.
Results: As regard ABG in lung contusion cases, PH, PCO2 cannot predict pneumonia but can significantly predict ARDS. Hco3 cannot predict pneumonia nor ARDS. Spo2, PaO2, P/F, Aa DO2, Aa DO2 augmentation, PaO2 deficit, a/A O2 tension ratio can significantly predict pneumonia and ARDS.  Both ABG abnormalities and increased contusion volume were associated with higher complication rates. However, CT-based contusion volume demonstrated superior predictive accuracy, particularly for pneumonia and ARDS. Specific cutoff values (>0.19 for pneumonia and >0.429 for ARDS) showed high sensitivity, specificity, and negative predictive value, outperforming individual ABG-derived indices.
Conclusions: While both ABG analysis and CT imaging provide important prognostic information, CT-calculated PC volume proved to be a more reliable predictor of complications following blunt chest trauma.