Non-invasive positive pressure ventilation for severe thoracic trauma

A 35-year-old man was admitted to the intensive care unit (ICU)following a road traffic accident. He had sustained severe traumato the left side of his chest, as well as other musculoskeletalinjuries. After a short initial period of ventilation of thelungs via a tracheal tube, he was managed using a combinationof continuous positive airway pressure and non-invasive positivepressure ventilation. He avoided ventilator-associated pneumonia,and spent a large part of his time on the ICU without any invasivemonitoring lines, another potential focus of infection. He wasdischarged from the ICU after 25 days without having sufferedany septic complications. The role of non-invasive positivepressure ventilation in severe thoracic trauma is discussed. Br J Anaesth 2000; 85: 788–90 ^* Corresponding author