Role of HVNI in Severe Chest Trauma

Inclusion Criteria: * Chest trauma patients with lung injury confirmed by ct imaging * the age from 15-55 years old * No indication of mechanical ventilation at the time of admission to the intensive care unit Exclusion Criteria: * • Patients \< 15years old * requiring endotracheal intubation and mechanical ventilation immediately on admission for any cause * facial fractures or base of skull fractures * Who did not receive a chest computed tomography (CT) scan * Glasgow Coma Scale \<10 * Massive surgical emphysema * COPD Patients ( chronic obstructive pulmonary disease )