Resolution of left lower lobe collapse postesophagectomy using the medivent RTX respirator, a novel noninvasive respiratory support system

THIS IS THE FIRST case report describing the use of a novel noninvasive respiratory support device, the RTX respirator (Medivent Ltd, London, UK) (Fig 1), for clearance of intractable secretions postesophagectomy. The patient had left lower lobe collapse and incipient respiratory failure. Routine postoperative physiotherapy techniques, combined with continuous positive airway pressure (CPAP) via a surgical tracheostomy, failed to clear retained sputum. The RTX respirator provided chest physiotherapy in the form of high-frequency oscillation interrupted by a "cough" phase to loosen and expel secretions (secretion clearance mode). These maneuvers allowed reinflation of the lobe, and the patient recovered. The mode of operation of the RTX respirator, and the properties of the device that may have contributed to the patient's recovery, are discussed.