Blood gas analysis in management of flail chest injuries

Six cases of flail chest injury were studied for changes in blood gases and acid-base status before and during respiratory management. Metabolic acidosis and mild to severe hypoxemia were found in most patients with flail chest at the time of admission, and there was a relationship between manifestation of paradoxical respiration and hypercarbia. Serial blood gas determinations are extremely important in assessment of the adequacy of the therapy, particularly in management of flail chest with continuous IPPB therapy.