Pneumothorax Flashcards
What is the definition of a pneumothorax?
Air in the pleural space leading to partial or complete collapse of the lung
How common is a pneumothorax?
Primary spontaneous pneumothorax: 24/100000 a year in men and 9.9/100000 in woman in England
What is the pathology of a pneumothorax?
(see sheet for x rays)
• Tension pneumothorax:
• Air passes in during inspiration but unable to exit during expiration
• Unilateral ↑ in intrapleural pressure
What are the risk factors/aetiology of a pneumothorax?
- Young men that are tall and thin e.g. Marfans – rupture of pleura due to congenital defect in connective tissue of the alveolar wall
- Spontaneous
- Underlying lung disease e.g. COPD
- Mechanical ventilation – tension pneumothorax
- Nasal non invasive ventilation – tension pneumothorax
What are the signs/symptoms of a pneumothorax?
• Sudden onset of pleuritic chest pain • Sudden onset of breathlessness • ↓ breath sounds • Hyperresonant percussion Tension = tracheal deviation • Sweating • Distressed patient • Tachycardic
What diseases present similarly to a pneumothorax?
- Pleural effusion
- Chest pain
- PE
What investigations are required to diagnose a pneumothorax?
- Tension = clinical
- CXR
- CT – differentiates emphysematous bullae from pneumothoraces
What information should a patient with a pneumothorax be given about flying and driving?
Patients are advised not to fly for 2 weeks after successful treatment
Patients are advised not to dive unless surgery is performed to prevent recollapsing of the lung
What are the surgical treatments for pneumothorax?
- Tension pneumothorax:
- Immediate decompression by needle thoracocentesis (2nd intercostal space, mid clavicular line)
- Intercostal tube drainage
- Aspiration of air
- Pleurectomy – removal of pleura
- Pleurodesis – pleural space is artificially obliterated
What are the pharmacological treatments for pneumothorax?
• High flow oxygen
What are the non pharmacological treatments for pneumothorax?
- Avoid strenuous activity
* Smoking cessation
