July 1978

Flail Chest Syndrome and Pulmonary Contusion

Author Affiliations

From the Respiratory Care Service (Drs Parham and Redding), Department of Anesthesiology and Trauma Service (Dr Yarbrough), Department of Surgery, Medical University of South Carolina, Charleston.

Arch Surg. 1978;113(7):900-903. doi:10.1001/archsurg.1978.01370190122027

• Controlled mechanical ventilation has been the mainstay of treatment in the flail chest syndrome for more than 20 years. Retrospective studies have recently suggested that the technique is unnecessary, and they infer that spontaneous ventilation or intermittent mandatory ventilation are equally effective. The common theme of these investigations is that mechanical ventilation is required only to relieve hypoxemia associated with the underlying contusion. In two cases of flail chest, spontaneous respiratory efforts resulted in complete disruption of the fracture sites and thus prolonged the duration of mechanical ventilation that was required. In severe cases of flail chest syndrome, there is still a need for controlled mechanical ventilation to splint the rib fractures in a position which facilitates union of the fragments.

(Arch Surg 113:900-903, 1978)