Pneumothorax: symptoms and treatment, causes of pneumothorax
The lungs of each person function correctly only under conditions where the pressure in them is greater than the pressure in the pleural region.
If the air gets anyway into the pleural area, the pressure will increase. The lungs in this case will quickly fall off, which will cause quite a perceptible difficulty in breathing and other symptoms associated with lack of oxygen.
This situation is called "pneumothorax", that is, a state where air or gases accumulate in the pleural region. Pneumothorax may occur after trauma, illness or as a complication after treatment or diagnostic actions.
How does pneumothorax develop, and what is it? The disease develops under the influence of a variety of different causes that determine the form of this condition. Thus, the following classification of pneumothorax can be distinguished:
Valve pneumothorax is the most dangerous, since air movement in this case is directed exclusively to the pleural area and does not leave it. The pressure in the region is rapidly increasing, which affects the human condition in a negative way, often leading it to shock.
The first symptoms of pneumothorax begin with acute pain in the chest, which can give to the shoulder from the affected area, the neck or the upper abdomen.
Unpleasant sensations are noted during breathing or movement. As the symptoms of pneumothorax develop, a person begins to feel chest tightness and lack of air, which is explained by the increasing pressure in the pleural area and compression of the lung. There is shortness of breath, shallow and frequent breathing, which does not bring relief.
The person continues to feel acute shortage of oxygen, which leads to the appearance of pallor of the skin, and in the acute case of pneumothorax develops cyanosis of the skin. In addition, there is a rapid heartbeat and a marked sweating.
Correct and timely diagnosis is extremely important in the case of pneumothorax, as the condition is often dangerous and often complicates.
In the diagnosis of pneumothorax, the characteristic appearance of the patient, which combines all the symptoms of the disease, primarily helps. In addition, a person assumes a certain posture, most often a sitting or semi-sitting position, in which pressure in the pleural area is not so strongly felt.
Of course, one external symptomatology for establishing a diagnosis is not enough, so apply the method of radiography of the chest, which is very informative in cases of pneumothorax. Radiography can identify the affected area, identify the edges of the collapsed lung, the displacement of the mediastinum, the location of the pleura, etc.
In some cases, when X-rays may not be sufficient or it does not show pneumothorax pictures with obvious symptoms, a CT scan can be used.
In addition, as an auxiliary measure, a blood test for the gas content is used, which shows the level of hypoxemia, as well as electrocardiography, which provides information on the work of the heart against pneumothorax.
It is extremely necessary for the injured person to provide rapid first aid. In the case of an open pneumothorax, a wound dressing is necessary, which will prevent further ingress of air into the pleural region.
In addition, the patient needs to ensure peace of mind until the ambulance car arrives. Calling for skilled care for pneumothorax is necessary in the first place, since in most cases a person is unable to cope with this condition independently.
Treatment of pneumothorax is to remove air and fluid from the pleural area. This is achieved by needle puncture in the II / III intercostal space along the mid-succinic line. If the puncture did not help in removing the air, the pleural region is drained until the lung is fully opened. It is worth noting that such actions are adequate only for closed pneumothorax.
Of course, not always pneumothorax can be so dangerous. In some cases, when the symptoms are not pronounced brightly, and there is either no or barely expressed breathing disorder, only symptomatic treatment is required. Excess air in this case will independently resolve. The main thing - to comply with bed rest with strict restriction of movement.
The outcome of pneumothorax depends on many factors, for example, the sex and age of the victim, the concomitant diseases, the presence of complications, etc. Spontaneous pneumothorax, due to heredity or various diseases, has in most cases a favorable outcome.
Unfortunately, in 20% of cases there is a relapse of pneumothorax, especially if it is caused by a primary disease. Only treatment of a primary disease will significantly reduce the risk of relapse.
A person's condition is dangerous when the pleural area is filled with air from both sides, which leads to an acute disruption of respiratory function as a result of the asleep lungs, as well as to further possible complications.
In the event that pneumothorax develops as a result of injuries, the outcome depends entirely on the nature and severity of the injuries.
It should be noted that in the presence of lung pathology, there is a high risk of subsequent attacks of pneumothorax, which significantly reduces a person's standard of living and, in addition, presents a real threat to life. Treatment of such pneumothorax consists in the removal of pathology. In this case, the forecast can be favorable.
More than half of the victims of pneumothorax develop various complications. The most common complication is bleeding into the pleural region, which most often has a favorable outcome.
In cases of traumatic pneumothorax, there is a risk of infection of the open wound, as well as the development of subcutaneous emphysema. At her air gets into the subcutaneous fat, which in itself is not a dangerous condition, except when the emphysema reaches the mediastinum.
A frequent complication of pneumothorax is also considered inflammation of the pleural lobes, which is accompanied by a number of severe symptoms and requires thorough treatment.
In addition to all of the above, pneumothorax often returns, bringing with it new complications. That is why it is so important to correctly identify the causes of pneumothorax and undergo adequate treatment.
If the air gets anyway into the pleural area, the pressure will increase. The lungs in this case will quickly fall off, which will cause quite a perceptible difficulty in breathing and other symptoms associated with lack of oxygen.
This situation is called "pneumothorax", that is, a state where air or gases accumulate in the pleural region. Pneumothorax may occur after trauma, illness or as a complication after treatment or diagnostic actions.
Causes of pneumothorax and types of disease
How does pneumothorax develop, and what is it? The disease develops under the influence of a variety of different causes that determine the form of this condition. Thus, the following classification of pneumothorax can be distinguished:
- 1) Spontaneous. It occurs for no apparent reason( primary) or against the background of the disease( secondary).Most often observed in young men between the ages of 20 to 40 years. The basis of pneumothorax, as a rule, is predisposition or congenital defect of the lungs. In addition, diseases such as cystic fibrosis( see symptoms of cystic fibrosis), severe asthma, tuberculosis, pneumonia, lung abscess, rheumatoid arthritis, lung tumors, may be the cause of the development of spontaneous pneumothorax.
- 2) Traumatic. Occurs as a result of a thoracic injury. In this case, pneumothorax develops from both a penetrating wound and internal trauma. In the first case, air enters the pleural cavity from an open wound, but it is also removed from it. Such a state creates the effect of "paradoxical breathing", when the lung falls down on the inhalation and expands on exhalation. In the second case, there is a rupture of the lung or bronchus, from which the air freely penetrates into the pleural region.
- 3) Iatrogenic. Occurs as a result of therapeutic or diagnostic manipulation by type of complication. Examples of such manipulations include lung or pleural biopsy, puncture, catheterization, etc.
Valve pneumothorax is the most dangerous, since air movement in this case is directed exclusively to the pleural area and does not leave it. The pressure in the region is rapidly increasing, which affects the human condition in a negative way, often leading it to shock.
Symptoms of pneumothorax
The first symptoms of pneumothorax begin with acute pain in the chest, which can give to the shoulder from the affected area, the neck or the upper abdomen.
Unpleasant sensations are noted during breathing or movement. As the symptoms of pneumothorax develop, a person begins to feel chest tightness and lack of air, which is explained by the increasing pressure in the pleural area and compression of the lung. There is shortness of breath, shallow and frequent breathing, which does not bring relief.
The person continues to feel acute shortage of oxygen, which leads to the appearance of pallor of the skin, and in the acute case of pneumothorax develops cyanosis of the skin. In addition, there is a rapid heartbeat and a marked sweating.
Diagnosis
Correct and timely diagnosis is extremely important in the case of pneumothorax, as the condition is often dangerous and often complicates.
In the diagnosis of pneumothorax, the characteristic appearance of the patient, which combines all the symptoms of the disease, primarily helps. In addition, a person assumes a certain posture, most often a sitting or semi-sitting position, in which pressure in the pleural area is not so strongly felt.
Of course, one external symptomatology for establishing a diagnosis is not enough, so apply the method of radiography of the chest, which is very informative in cases of pneumothorax. Radiography can identify the affected area, identify the edges of the collapsed lung, the displacement of the mediastinum, the location of the pleura, etc.
In some cases, when X-rays may not be sufficient or it does not show pneumothorax pictures with obvious symptoms, a CT scan can be used.
In addition, as an auxiliary measure, a blood test for the gas content is used, which shows the level of hypoxemia, as well as electrocardiography, which provides information on the work of the heart against pneumothorax.
Treatment of pneumothorax
It is extremely necessary for the injured person to provide rapid first aid. In the case of an open pneumothorax, a wound dressing is necessary, which will prevent further ingress of air into the pleural region.
In addition, the patient needs to ensure peace of mind until the ambulance car arrives. Calling for skilled care for pneumothorax is necessary in the first place, since in most cases a person is unable to cope with this condition independently.
Treatment of pneumothorax is to remove air and fluid from the pleural area. This is achieved by needle puncture in the II / III intercostal space along the mid-succinic line. If the puncture did not help in removing the air, the pleural region is drained until the lung is fully opened. It is worth noting that such actions are adequate only for closed pneumothorax.
In the case of open pneumothorax, when air comes from the external environment and the torn lung, surgical intervention is necessary, involving lung suturing and wounds, followed by drainage.
Of course, not always pneumothorax can be so dangerous. In some cases, when the symptoms are not pronounced brightly, and there is either no or barely expressed breathing disorder, only symptomatic treatment is required. Excess air in this case will independently resolve. The main thing - to comply with bed rest with strict restriction of movement.
Predicting the treatment of pneumothorax
The outcome of pneumothorax depends on many factors, for example, the sex and age of the victim, the concomitant diseases, the presence of complications, etc. Spontaneous pneumothorax, due to heredity or various diseases, has in most cases a favorable outcome.
Unfortunately, in 20% of cases there is a relapse of pneumothorax, especially if it is caused by a primary disease. Only treatment of a primary disease will significantly reduce the risk of relapse.
A person's condition is dangerous when the pleural area is filled with air from both sides, which leads to an acute disruption of respiratory function as a result of the asleep lungs, as well as to further possible complications.
Two-sided pneumothorax is noted as a favorable outcome in only 50% of cases, but this number is strongly influenced by the speed and quality of the medical care provided.
In the event that pneumothorax develops as a result of injuries, the outcome depends entirely on the nature and severity of the injuries.
It should be noted that in the presence of lung pathology, there is a high risk of subsequent attacks of pneumothorax, which significantly reduces a person's standard of living and, in addition, presents a real threat to life. Treatment of such pneumothorax consists in the removal of pathology. In this case, the forecast can be favorable.
Consequences of
More than half of the victims of pneumothorax develop various complications. The most common complication is bleeding into the pleural region, which most often has a favorable outcome.
But in case of extensive bleeding within a few hours, a fatal outcome may occur. In addition, there is a risk of acute respiratory and heart failure, both of which are considered life-threatening.
In cases of traumatic pneumothorax, there is a risk of infection of the open wound, as well as the development of subcutaneous emphysema. At her air gets into the subcutaneous fat, which in itself is not a dangerous condition, except when the emphysema reaches the mediastinum.
A frequent complication of pneumothorax is also considered inflammation of the pleural lobes, which is accompanied by a number of severe symptoms and requires thorough treatment.
In addition to all of the above, pneumothorax often returns, bringing with it new complications. That is why it is so important to correctly identify the causes of pneumothorax and undergo adequate treatment.