Effects of Non-invasive Ventilation Therapies on the Lung in Hypoxemic Chest Trauma Patients

Inclusion criteria

• Age > 18 years old
• Chest trauma < 5 days
• At least 3 ribs fracture on initial CT-scan
• Need of oxygen moderated to maintain monitoring oxygen saturation Sp02 > 92% or partial pressure of arterial oxygen Pa02/ Fraction of inspired oxygen FiO2 > 200
• Intensive Care Unit admission
• Need a chest CT control during the five first days after the trauma

Exclusion criteria

• Patient intubated or with respiratory failure : measured or estimated Pa02/FiO2 < 200 or indication for intubation (several with respiratory rate > 35/min, abundant tracheal secretions, significant increase in work of accessory respiratory muscles on inspiration, signs of respiratory exhaustion on arterial blood gas with The potential of Hydrogen pH < 7,3 or PaCO2 > 50 mmHg, severe hypoxemia with PaO2/FiO2 ratio < 100 or desaturation < 88% for more than 5 minutes)

• Inability to maintain 10 seconds of apnoea required for scan acquisition
• Patient treated with ventilatory support by NIV or HFO in the 12 hours prior the investigation
• Uncontrolled circulatory failure with need for introduction of Noradrenaline > 0,15 ug/kg/min
• Uncontrolled neurological failure with Glasgow Coma Scale (CGS < 15
• Unstable facial trauma or with pneumocephalus or basilar skull trauma
• Large, undrained pneumothorax with lateral separation at the level of the hilum > 2 cm and extensive throughout the axillary line
• Patients with identified cognitive impairment
• Persons deprived of liberty, persons under protective measures
• Persons not affiliated to a social security insurance
• Current pregnancy or breastfeeding
• Refusal to participate in the study