A man in his 70s underwent emergency hospitalization 6 hours after his chest had been compressed by a tractor. Respiratory rate was elevated and moist rales were heard in both lungs. Neither flail chest nor subcutaneous emphysema was observed. PO₂ decreased to 62.6 mmHg under high-concentration oxygen administration. Fractures of the left third through tenth and right third through eleventh ribs were present, and bilateral pulmonary contusions and hemothorax were diagnosed. Analgesics were

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... istered for pain control. PO₂ remained unimproved 10 hours after admission. Non-invasive positive-pressure ventilation(NPPV)was applied, after which respiratory status improvement and satisfactory pain control were achieved. Oral intake in the form of a high-density liquid diet was initiated 48 hours after commencing NPPV. NPPV was discontinued 84 hours after commencement, and the patient was then transferred to another hospital on the 9 th hospital day. The present case suggests that NPPV can be effective in better ventilation and treatment of lung edema in conscious patients with blunt chest trauma under good pain control.