title: [Flail chest rescued by mechanicalventilation with early tracheotomy and physiotherapy; report of a case].
abstract: A 73-year-old man hit his fore-chest accidentally when he rode his motorcycle. A huge flail chest was observed on his central fore-chest, and multiple fractures of costal cartilage were suspected. He developed pneumonia on the 4th hospital day, and he was intubated and mechanical ventilation was initiated. Because frequent sputum aspiration was necessary and aggressive physiotherapy was desirable, a tracheotomy was performed on the same day of intubation. He recovered from respiratory failure with conservative therapy and the mechanical ventilation was disconnected 13 days later. Tracheotomy in the early phase of respiratory failure with flail chest was very effective and the surgical fixation of flail segment would not be necessary even in the case of 'stove-in chest' like the present case.
authors.affiliation: Department of General Thoracic Surgery, Himeji Red Cross Hospital, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Nagahiro
authors.forename: Yoshitesu
authors.initials: Y
authors.lastname: Doi
authors.forename: Sshisan
authors.initials: S
authors.lastname: Sato
authors.forename: Shintaro
authors.initials: S
authors.lastname: Nanba
authors.forename: Noriko
authors.initials: N
authors.lastname: Ishii
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yaida
authors.forename: Takae
authors.initials: T
authors.lastname: Niguma
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kurasako
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D000063:Accidents, Traffic; D000368:Aged; D005409:Flail Chest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D012121:Respiration, Artificial; D013898:Thoracic Injuries / Q000150:complications; D014139:Tracheostomy