Acute Respiratory Failure in Severe Blunt Chest Trauma

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Abstract
From 1973-1980, 144 patients with chest trauma were treated. Concomitant acute respiratory failure was considered severe in 125 (83%). Morbidity and mortality were related to the presence of shock, head injury Glasgow score 3-4; and size of the flail segment, but not to the extent of the thoracic or intrathoracic injuries. Mortality for the whole group and for the flail chest group were 8.3 and 9.5%, respectively. Treatment was analyzed in 2 historical periods. In the first, 1973-1976, controlled mandatory ventilation and tracheostomy were used in 83 and 70% of the cases, respectively. In the 2nd period, 1977-1980, intermittent mandatory ventilation plus soft-cuff endotracheal tube were used in 77% of the cases. Ventilator time did not vary in these 2 periods, but the lung O2 transport was better in the group treated with intermittent mandatory ventilation.

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