title: Conservative management of flail chest after cardiopulmonary resuscitation by continuous negative extrathoracic pressure.
abstract: Flail chest after blunt trauma usually requires good pain control and positive pressure support. Continuous negative extrathoracic pressure (CNEP) causes a splinting effect around the anterior chest wall and upper abdomen which increases functional residual capacity and improves lung mechanics. We report an 82-year-old woman with flail chest after cardiopulmonary resuscitation. She underwent mechanical ventilation, with two failed attempts at extubation. She was subsequently ventilated non-invasively using CNEP, allowing early successful extubation. This case illustrates the use of CNEP for weaning and ventilating patients with flail chest after blunt trauma.
authors.affiliation: Medical Intensive Care Unit, Hadassah Hospital, Jerusalem, Israel.
authors.forename: David M
authors.initials: DM
authors.lastname: Linton
authors.forename: Sigal
authors.initials: S
authors.lastname: Sviri
mesh_terms: D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D005260:Female; D005409:Flail Chest / Q000628:therapy*; D006801:Humans; D013898:Thoracic Injuries / Q000150:complications; D015919:Ventilators, Negative-Pressure; D014949:Wounds, Nonpenetrating / Q000150:complications