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The use of continuous positive airway pressure in blast injury of the chest

A 15-year-old boy suffered blast injury of the lungs and developed acute respiratory distress with severe hypoxemia. The patient required mechanical ventilation with high-level PEEP, in the early postblast injury period. In order to reduce the risk of air embolization and barotrauma, we reverted to spontaneous breathing using intermittent mechanical ventilation (IMV) and continuous positive airway pressure (CPAP) as early as possible. The patient recovered after successful treatment. Treatment with IMV and CPAP is discussed and recommended in such cases.