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Respiratory: disorders of the pleura and chest wall > Pneumothorax > Flashcards

Flashcards in Pneumothorax Deck (17)
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1

what is a pneumothorax?

Collection of air in the pleural space resulting in a collapsed lung

2

what are the causes of pneumothorax in adults ?

primary

secondary

marfans syndrome

can be caused by iatrogenic causes and trauma

3

what are the primary causes?

normal lungs then apical bullae rupture

4

what are the secondary causes?

pre-existing lung disease e.g. smoking, severe asthma, COPD

5

what is marfans syndrome?

a hereditary disorder of connective tissue, resulting in abnormally long and thin digits and also frequently in optical and cardiovascular defects.

6

what are some of the causes of pneumothorax in children?

Increased incidence with intermittent positive pressure ventilation (IPPV), Continuous positive airway pressure (CPAP) and ventilation

other risk factors - RDS (stiff lungs)

maybe because of problems with ventilation following RDS. Over- inflation of lungs

7

what are the symptoms of pneumothorax?

sudden onset pleuritic pain, shortness of breath and tachycardia

there may be no symptoms especially if young and fit

8

what are the symptoms of pneumothorax on a mechanically ventilated patient?

may present with hypoxia or an increase in ventilation pressures

9

what are some signs of pneumothorax?

Tachycardia
Hyper-resonant percussion note
reduced expansion
quiet breath sounds on auscultation
Hamman’s sign ( click on auscultation at left side )
pallor

10

what investigations should be done/

CXR

ABG - to see if they are hypoxic

CT chest

11

what may be seen on CXR?

CXR: collapsed lung and a sharpened defined edge of the deflated lung
may see mediastinal shift

small if 2cm

12

why is a CT useful?

useful to differentiate bullous lung disease

13

what is the treatment ?

Oxygen if there is no drain in

needle aspiration (2nd Intercostal space, mid-clavicular line)

chest drain if recurs using large bore cannula into the 5th mid-axillary line

if it is asymptomatic and small - no treatment is needed

maybe surgical intervention needed

14

why may surgery be needed?

2nd ipsilateral ptx

1st contralateral ptx

bilateral spontaneous ptx

spontaneous haemothorax

if there has been > 5 days of persistent air leak (drainage)

if it’s the 1st ptx of someone with a high risk occupation - e.g. diving or flying

15

what can a tension pneumothorax lead to?

can lead to cardiac arrest due to one-way valve mechanism (between pleural layers) resulting in increasing pressure in pleural space

acute respiratory distress

16

what are the signs?

tracheal deviation and mediastinal shift to opposite side, hypotension, raised JVP, reduced air entry

17

what are they treated with?

treated with Oxygen and needle compression usually with large bore venflon in the 2nd intercostal space