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Ann Thorac Surg 1975;20:170-176
© 1975 The Society of Thoracic Surgeons

Articles

Control of Respiratory Therapy in Flail Chest

Frank Lewis, Jr., M.D.*, Arthur N. Thomas, M.D., Richard M. Schlobohm, M.D.

From the Departments of Surgery and Anesthesiology, University of California at San Francisco General Hospital, San Francisco, Calif.

* Address reprint requests to Dr. Lewis, Department of Surgery, 13 Solarium, San Francisco General Hospital, 1001 Potrero Ave., San Francisco, Calif. 94110.

Pulmonary mechanics and oxygenation were measured in 24 consecutive patients with posttraumatic flail chest requiring continuous mechanical ventilation. The mean duration of mechanical ventilation was fourteen days. Mortality was 38% for all patients, 29% if deaths from head injury are excluded. Pneumonia occurred in 4 patients (17%) and pneumothorax in 1 (4%). Vital capacity and maximal inspiratory force measurements were useful in assessing chest wall stabilization. Total lung compliance correlated negatively with fatal outcome from respiratory failure. The alveolar-arterial oxygen gradient was not useful in assessing chest wall stabilization.




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