Pneumothorax Support Group

It can result from: a penetrating chest wound, barotrauma to the lungs, spontaneously (most commonly in tall, slim young males who smoke), chronic lung pathologies including emphysema, asthma, acute infections, chronic infections eg TB, cancer

Pneumathoraces 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. The remorseless increase in intrathoracic pressure results in massive shifts of the mediastinum away from the affected lung compressing intrathoracic vessels. A non-tension pneumothorax by contrast is a less severe pathology because the air in the pneumothorax is able to escape.

Small Pneumothoraces require no treatment other than repeat observation via Chest X-rays.

Larger Pneumothoraces may require tube thoracostomy, also known as chest tube placement. A tube is inserted into the chest wall outside the lung and air is extracted using a simple one way valve or vacuum and a water valve device, depending on severity. This allows the lung to re-expand within the chest cavity. The pneumothorax is followed up with repeated X-rays. If the air pocket has become small enough, the vacuum drain can be clamped temporarily or removed.

In case of penetrating wounds, these require attention, but generally only after the airway has been secured and a chest drain inserted. Supportive therapy may include mechanical ventilation.

Recurrent pneumothorax may require further corrective and/or preventative measures such as pleurodesis. If the pneumothorax is the result of bullae, then bullaectomy (the removal or stapling of bullae or other faults in the lung) is preferred. Pleurodesis is the injection of a chemical irritant that triggers an inflammatory reaction, leading to adhesion of the lung to the parietal pleura. Substances used for pleurodesis include talc, blood and bleomycin.