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Pneumothorax - Spontaneous Pneumothorax

Collapse of part or all of a lung caused by pressure from free air in the chest between the two layers of the pleura (thin membranes that cover the lung). Peak incidence is in males between ages 20 to 40.

Pneumothorax can occur for no apparent reason, called a spontaneous pneumothorax, or can be caused by injury. The most serious type is a tension pneumothorax, where the chest cavity fills with air and the extreme pressure causes the lung to collapse completely.

Causes

Air leaks occur when the alveoli (tiny air sacs) become over distended and burst. Pressure of the air delivered by mechanical ventilators (breathing machines) is the most common cause. Meconium aspiration (inhalation of the first stools passed in utero) can also trap air and lead to over distention (the lungs expand too much) and air leaks. Air leaks often occur in the first 24 to 36 hours when lung disease is at its peak. Some otherwise healthy babies can develop a "spontaneous" air leak that does not cause symptoms or distress.

Signs and symptoms

The following symptoms vary according to the degree of lung collapse and extent of underlying lung disease. Symptoms may be less acute if the pneumothorax develops slowly:

• Sharp chest pain. Pain may extend to a shoulder or across the chest or abdomen.
• Shortness of breath and rapid breathing.
• Dry, hacking cough (occasionally).
• Bluish nails.
• Coughing bloody sputum (sometimes).
• Rapid pulse.
• In worst cases (tension pneumothorax), fainting and shock.

Diagnosis

To diagnose a pneumothorax, a doctor will check for normal breathing sounds by listening to the patient's chest with a stethoscope. He or she will also order a chest x-ray, which will show any air pocket in the chest cavity and the condition of the lung. If tension pneumothorax is suspected, an electrocardiogram (ECG) lets the doctor see the rate and rhythm of the heart. A test called an arterial blood gas is also used to check a blood sample for oxygen and carbon dioxide levels.

Treatment

Medical Treatment- Hospitalization and treatment with special equipment following minor surgery may be necessary.

Medication

Medication usually is not necessary. However, you may use non-prescription drugs such as acetaminophen for minor pain. For severe pain, your doctor may prescribe stronger pain relievers.

Home Treatment

• Don't exercise during healing, but resume normal activities- including the one that triggered the pneumothorax-after clearance from your doctor.
• Don't smoke.
• Try not to cough.
• Avoid loud talking, laughing or singing.
• You may be more comfortable if you rest in a sitting or semi-reclining position.

Prevention

• Learn and use proper techniques for activities at risk listed above (especially ascending in scuba diving).
• Obtain medical treatment for lung disorders such as asthma or emphysema.
• Don't smoke.