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.