الفهرس 
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Abstract
A pulmonary contusion is an injury to the lung parenchyma in the absence of laceration to lung tissue or any vascular structures. It usually results from blunt chest trauma, shock waves associated with penetrating chest injury, or explosion injuries Pulmonary contusion depending on the nature and severity of the trauma and the condition of the patient who suffers the injury, the outcome can range from a transient discomfort to a sudden death. HTS solution, by absorbing water from the submucosa, can theoretically reverse some of the submucosal and adventitial edema and decrease the thickness and dryness of the mucous plaques inside the bronchiolar lumen. Nebulized HTS treatments disrupt the interaction between glycosaminoglycans and IL-8, rendering IL-8 susceptible to proteolytic degradation with subsequent decrease in neutrophil chemotaxis; all of this ultimately reducing inflammation. Consequently, we hypothesize that inhaled HTS modulates the pulmonary epithelial inflammatory response following lung contusion and has a role in management of lung contusion. We have two groups in this study ,every group consists of 40 patients ,both of them complaining of lung contusion • Two groups were treated according to European trauma society reference by Pain control , supplemental oxygen and pulmonary toilet . fluid resuscitation with crystalloid to euvolemia appears appropriate. But the two groups were different as the following: First group (Hypertonic group) was treated with supplemental oxygen plus inhaled HTS 3times daily for one week or improvement of patient. Second group (Control group) was treated with supplemental oxygen plus inhaled water. We assessed patients by pulse oximetry and cardiorespiratory monitor to follow the vital signs of patients including, respiratory rate, heart rate, and blood pressure. Dyspnea was assessed using the MBS .We followed up patients by ABG and Lung Ultrasound Score. The results of the present study revealed that there was no significant difference regarding baseline demographic data, including age, and sex between the two studied groups (P > 0.05). There was statistically insignificant difference in pulmonary contusion scoring system in group I as compared to group II at all (P ˃ 0.05). • There was significant increase of f PaO2 ،Spo2 at group I when compared to group II . There was significant decrease of respiratory rate at group I when compared to group II . There was insignificant decrease of heart rate at both groups According to our outcome : Primary outcome : 7 patients (17.5%) were intubated and mechanically ventilated in group I . with mean value of duration of ventilation 4.24±0.38. But at group II 15 patients (37.5%) were intubated and mechanically ventilated with mean value of duration of ventilation 6.53±0.40. There was statistically significantly difference of duration of ventilation between two groups significantly decrease of duration of ventillation at group I when compared to group II (P < 0.05) and There was statistically significantly difference in rate of intubation between two groups significantly decrease of numbers of patients who were intubated at group I when compared to group II (P < 0.05) Secondary outcome: Mean of duration of ICU stay was 8.47±4.38 and 10.20±4.59 at group I (cases) and group II (control) respectively . • In this study 4 cases of mortality were recorded in group I and 13 cases of mortality were recorded in group II. There was statistically significant different between both groups (P < 0.05).