Pneumothorax - Causes, Symptoms and Treatment

A pneumothorax is collection of air or gas in the space surrounding the lungs. Spontaneous pneumothorax is a sudden collection of air or gas in the chest that causes the lung to collapse in the absence of a traumatic injury to the chest or lung.  Pneumothoraces are divided into tension and non-tension pneumathoraces. A tension pneumathorax is a medical emergency as air accumulates in the pleural space with each breath. In pneumothorax ,air gets within the chest and can prevent a lung from expanding normally. With lung capacity diminished, the body does not get enough oxygen and the skin and lips turn blue (cyanosis). A tension pneumothorax is a life-threatening condition caused by air within the pleural space that is under pressure; displacing mediastinal structures and compromising cardiopulmonary function.

A pneumothorax may become life-threatening if the pressure in your chest prevents the lungs from getting enough oxygen into the blood. If the surface tension is broken by an air leak into this space, the lungs partially collapse and respiration is compromised. With pneumothorax, it may hurt to breathe and the victim, already short of breath from the collapsed lung, may breathe only shallowly and even may try to hold his breath because of the pain. In the most serious instances of pneumothorax, a physician will insert a plastic tube into the chest under local anesthesia. To this he will attach an instrument called the Heimlich Chest Drain Valve, which allows air to leave the chest and prevents reentry. With the valve, patients may be sent home without need for hospitalization. But that may make matters worse, creating a sense of suffocation and leading to anxiety and restlessness. Occasionally, after pneumothorax, the lung does not expand fully and surgery is necessary.

Pneumothorax, or air in the intrapleural space, traditionally has been treated with tube thoracostomy (chest tube placement) with inpatient admission. If air enters the pleural space, the pressure in the pleural space becomes greater than that in the lungs, and the lung collapses partially or completely. The intrapleural space is normally just a 'potential space' that exists between two layers of 'pleura' - thin tissue layers, one of which covers lungs, and one of which lines the chest cavity. If a pneumothorax is severe or the baby is otherwise compromised (for example with respiratory distress syndrome), surgical placement of a plastic suction tube may be done to suck out the air as it leaks out into the pleural space around the lung.

Causes of Pneumothorax

The most comman causes of Pneumothorax include the following :

• Pressure of the air delivered by mechanical ventilators (breathing machines) is the most common cause.
• pneumothorax is usually caused by an injury to the chest, such as a broken rib or puncture wound.
• Common causes of pneumothorax are a penetrating chest injurytrauma, atmospheric overpressure, and preexisting lung disease; a pneumothorax may also occur spontaneously without apparent cause.
• Rupture of subpleural apical emphysematous blebs (accumulation of air between the layers of the visceral pleura that is not confined by connective tissue septa)
• Smoking (increases the risk of a first spontaneous pneumothorax by more than 20-fold in men and by nearly 10-fold in women, compared with the risks in nonsmokers)
• Transthoracic needle aspiration procedures (most common cause, accounting for 32-37% of cases)
• Subclavian and supraclavicular needle sticks

Symptoms of Pneumothorax

Some sign and symptoms related to Pneumothorax are as follows :

• Sudden shortness of breath , cyanosis (turning blue) and pain felt in the chest and/or back are the main symptoms.
• Dyspnea (shortness of breath)
• Bluish color of the skin caused by lack of oxygen
• Arterial blood gases
• Rapid respiratory rate
• Breathing or coughing makes pain worse
• Cough
• difficulty hearing breath sounds when listening with a stethoscope
• change in the location of heart or lung sounds when the organs are moved by the presence of air

Treatment of Pneumothorax

Some treatment of Pneumothorax are as follows :

• your baby's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• supplemental oxygen
• One standard first aid treatment is to cover the wound with pressure bandage(s) made air-tight with petroleum jelly or clean plastic sheeting.
• Supplemental oxygen may be needed to help air around the lung be reabsorbed more quickly.
• Removal of air is done by inserting a needle into the chest wall.
• A person who experiences pneumothorax more than once may require surgery.