Treatment of flail chest. Use of intermittent mandatory ventilation and positive end-expiratory pressure.

For the past two years we have treated patients with flail chest injuries and concomitant respiratory failure with intermittent mandatory ventilation (IMV) and positive end-expiratory pressure (PEEP). Prior to 1972 these patients were treated with controlled mechanical ventilation (CMV) until gross flailing ceased and inspiratory force and vital capacity measurements were adequate. We retrospectively studied the charts of 37 consecutive patients to compare the length of mechanical ventilatory support of patients managed by conventional CMV with those ventilated with IMV and PEEP. The mean ventilation time of patients treated with IMV and PEEP (5.1 +/- 4.7 days) was significantly less than that of the patients treated with CMV (18.8 +/- 14.4 days) (P less than .001).

[1]  R. Kirby,et al.  INTERMITTENT MANDATORY VENTILATION , 1974 .

[2]  C. F. Aldredge,et al.  PEEP vs ZEEP in the treatment of flail chest injuries , 1973, Critical care medicine.

[3]  J. Modell,et al.  The Effect of Incremental PEEP on Pa02 in Patients With Respiratory Failure , 1973, Anesthesia and analgesia.

[4]  S. F. Sullivan,et al.  Effects of Respiratory Alkalosis on Oxygen Consumption and Oxygenation , 1973, Anesthesiology.

[5]  R. W. Patterson,et al.  Ventilation-perfusion inequalities resulting from hypocapnic changes in lung mechanics. , 1972, The Journal of thoracic and cardiovascular surgery.

[6]  S. Cain,et al.  Effect of carbon dioxide on oxygen uptake during hyperventilation in normal man. , 1971, Journal of applied physiology.

[7]  K. Falke,et al.  Continuous Positive-Pressure Ventilation in Acute Respiratory Failure , 1970 .

[8]  H. Pontoppidan,et al.  Acute respiratory failure in the surgical patient. , 1970, Advances in surgery.

[9]  T. Petty,et al.  Continuous positive-pressure breathing (CPPB) in adult respiratory distress syndrome. , 1970, The Journal of thoracic and cardiovascular surgery.

[10]  E. Blair,et al.  Rationale of stabilization of the flail chest with intermittent positive pressure breathing. , 1968, The American surgeon.

[11]  K. Karlson,et al.  Severe blunt chest trauma. Studies of pulmonary mechanics and blood gases. , 1966, The Annals of thoracic surgery.

[12]  S. Stephenson,et al.  New technic for stabilization of the flail chest. , 1966, American journal of surgery.

[13]  J. F. Perry,et al.  CHEST INJURY DUE TO BLUNT TRAUMA. , 1965, The Journal of thoracic and cardiovascular surgery.

[14]  E. Crawford,et al.  THE FLAIL CHEST. AN ANALYSIS OF 100 PATIENTS. , 1963, American journal of surgery.

[15]  D. Williams,et al.  Treatment of flail chest injuries with a piston respirator. , 1963, American journal of surgery.

[16]  Benson Dw,et al.  Critically crushed chests; a new method of treatment with continuous mechanical hyperventilation to produce alkalotic apnea and internal pneumatic stabilization. , 1956 .

[17]  E. A. Cohen.  Treatment of the flail chest by towel clip traction. , 1955, American journal of surgery.

[18]  Jensen Nk.  Recovery of pulmonary function after crushing injuries of the chest. , 1952 .

[19]  F. Eggleston,et al.  A METHOD OF SKELETAL TRACTION APPLIED THROUGH THE STERNUM IN “STEERING WHEEL” INJURY OF THE CHEST , 1951, Annals of surgery.