Abstract
Acute respiratory failure is common in trauma patients and can be a threat to life in severe thoracic injury. We represent a case of severe respiratory failure after blunt thoracic injury with uncontrollable bleeding and massive air leak which was successfully managed with high frequency oscillatory ventilation. In our opinion high frequency oscillatory ventilation represent a safe and effective treatment of life threatening acute respiratory failure in trauma patients.
Highlights
Acute respiratory failure is common in adult trauma patients
We represent a case of severe respiratory failure after blunt thoracic injury with uncontrollable bleeding and massive air leak which was successfully managed with high frequency oscillatory ventilation
(3) There are some studies and case reports in the literature of successful use of HFOV in acute respiratory distress syndrome (ARDS) of non-traumatic aetiology [4,5,6,7] its use in trauma patients is limited. [1,2] We represent a case of severe respiratory failure after blunt thoracic trauma where high frequency oscillatory ventilation dramatically improved patient oxygenation without any serious complications
Summary
Acute respiratory failure is common in adult trauma patients. Sometimes it is so severe that conventional ventilatory support fails. [1,2] We represent a case of severe respiratory failure after blunt thoracic trauma where high frequency oscillatory ventilation dramatically improved patient oxygenation without any serious complications. In the first hours of ICU stay the patient was ventilated with volume controlled mode (tidal volume of 550 mL, frequency 24 /min, positive end expiratory pressure (PEEP) 4 cm H2O, inspiration to expiration ratio 1:1.3) and 100% oxygen in inspired gas mixture. He had inserted three chest tubes (one on the right and two on the left side). After six month of follow up the patient had no difficulties with breathing and on the chest x-ray only serial rib fractures were seen without pulmonary infiltrates or obliteration of costo-diafragmal recesses
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