High-Frequency Oscillating Ventilator Use in a Patient with Severe Pulmonary Contusions

Abstract

Approximately 25% of trauma deaths can be attributed to thoracic injuries. Severe pulmonary contusions commonly result from blunt trauma to the thorax. The resulting alveolar hemorrhage and edema can make oxygenation difficult or impossible by conventional ventilation methods. High-frequency oscillating ventilation (HFOV), which delivers small tidal volumes at high respiratory rates, may provide an alternative method of treatment for these patients. Although HFOV is approved for use only in neonatal and pediatric patients, it is a potentially valuable tool for ventilating adult patients who have severe pulmonary contusions when conventional methods fail.

This article reports the successful use of HFOV as a salvage ventilation technique in the treatment of an adult-sized pediatric patient who sustained multiple injuries and severe pulmonary contusions in a motor vehicle collision. The successful outcome for this patient should stimulate further investigation into the use of HFOV in the treatment of severe pulmonary contusions in adults.