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.