2015 Volume 29 Issue 3 Pages 364-367
A man in his 70s underwent emergency hospitalization 6 hours after his chest had been compressed by a tractor. Respiratory rate was elevated and moist rales were heard in both lungs. Neither flail chest nor subcutaneous emphysema was observed. PO2 decreased to 62.6 mmHg under high-concentration oxygen administration. Fractures of the left third through tenth and right third through eleventh ribs were present, and bilateral pulmonary contusions and hemothorax were diagnosed. Analgesics were administered for pain control. PO2 remained unimproved 10 hours after admission. Non-invasive positive-pressure ventilation (NPPV) was applied, after which respiratory status improvement and satisfactory pain control were achieved. Oral intake in the form of a high-density liquid diet was initiated 48 hours after commencing NPPV. NPPV was discontinued 84 hours after commencement, and the patient was then transferred to another hospital on the 9th hospital day. The present case suggests that NPPV can be effective in better ventilation and treatment of lung edema in conscious patients with blunt chest trauma under good pain control.
