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The main management's characteristics of the pulmonary contusion in the trauma patients are explained. From possible alveolocapillary membrane's injuries, with consideration of worsening evolution (ARDS, nosocomial infection, MOF), main points of discussion are circulation and mechanical ventilation. For the most severely injured, invasive monitoring is necessary, including the oxygenation parameters we now can dispose of. Quantification of extravascular lung water is an original and valuable tool to determine the time course and amount of pulmonary oedema. There is no ideal mode of ventilation but the basic ventilatory patterns must be adjusted; a target is the reduction of time requirement for ventilatory support.
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