How does a collapsed lung occur. What are the main symptoms of pneumothorax. When should you seek medical attention for chest pain and shortness of breath. How is a collapsed lung diagnosed and treated.

What is a Pneumothorax (Collapsed Lung)?

A pneumothorax, commonly known as a collapsed lung, occurs when air accumulates in the space between the lung and chest wall (pleural space). As this air builds up, it exerts pressure on the lung, causing it to collapse partially or fully. This condition impairs the lung’s ability to expand properly during inhalation, leading to breathing difficulties and other symptoms.

The severity of a pneumothorax can vary widely, from a small, self-resolving collapse to a life-threatening medical emergency. Understanding the causes, symptoms, and treatment options is crucial for anyone at risk or experiencing symptoms of this condition.

Common Causes of Pneumothorax

Pneumothorax can occur due to various reasons, ranging from traumatic injuries to underlying medical conditions. Some of the most common causes include:

• Chest injuries (e.g., fractured ribs, penetrating wounds)
• Chronic lung diseases (COPD, emphysema, cystic fibrosis)
• Asthma
• Lung cancer
• Mechanical ventilation
• Spontaneous occurrence (especially in tall, thin young adults)

Can pneumothorax occur without an apparent cause? Yes, a spontaneous pneumothorax can develop in individuals with no known lung disease or injury, particularly in young, tall, and thin males.

Recognizing the Symptoms of a Collapsed Lung

Identifying the symptoms of pneumothorax is crucial for seeking timely medical attention. The onset of symptoms is typically sudden and may include:

• Sharp, stabbing chest pain that worsens with breathing
• Sudden shortness of breath
• Rapid breathing (tachypnea)
• Increased heart rate
• Cyanosis (bluish discoloration of the skin due to lack of oxygen)
• Fatigue
• Dry, hacking cough

Are the symptoms of pneumothorax always severe? Not necessarily. In some cases, especially with a small pneumothorax, symptoms may be mild or even absent. However, any unexplained chest pain or difficulty breathing warrants medical evaluation.

Diagnosing Pneumothorax: Medical Tests and Procedures

Accurate diagnosis of pneumothorax is essential for appropriate treatment. Healthcare providers typically use a combination of physical examination and imaging studies to confirm the diagnosis:

Physical Examination

During the initial assessment, a doctor will:

• Listen to your chest with a stethoscope
• Tap on your chest wall to check for abnormal sounds
• Assess your breathing rate and pattern

Imaging Studies

To definitively diagnose pneumothorax, one or more of the following imaging tests may be ordered:

• Chest X-ray: The most common and initial imaging test
• CT scan: Provides more detailed images, especially for small pneumothoraces
• Ultrasound: Useful for rapid bedside assessment, particularly in emergency situations

Additional Tests

In some cases, additional tests may be necessary:

• Arterial blood gas analysis: To assess oxygen and carbon dioxide levels in the blood
• Electrocardiogram (ECG): To rule out cardiac causes of chest pain

How quickly can pneumothorax be diagnosed? With modern imaging techniques, a pneumothorax can often be diagnosed within minutes of a patient’s arrival at a healthcare facility.

Treatment Options for Collapsed Lung

The treatment approach for pneumothorax depends on its size, cause, and the patient’s overall health. Options range from conservative management to invasive procedures:

Observation

For small, uncomplicated pneumothoraces, observation may be sufficient. The body can often reabsorb the air over time, allowing the lung to re-expand naturally. During this period, supplemental oxygen may be provided to aid in the resolution.

Needle Aspiration

In cases where intervention is necessary, needle aspiration is often the first step. This procedure involves inserting a needle into the pleural space to remove the excess air.

Chest Tube Insertion

For larger pneumothoraces or when needle aspiration is insufficient, a chest tube may be inserted. This tube allows for continuous drainage of air until the lung fully re-expands.

Pleurodesis

In cases of recurrent pneumothorax, a procedure called pleurodesis may be recommended. This involves introducing an irritant into the pleural space to create inflammation, causing the lung to adhere to the chest wall and prevent future collapses.

Surgery

For persistent air leaks or recurrent pneumothoraces, surgical intervention may be necessary. This can involve video-assisted thoracoscopic surgery (VATS) or open thoracotomy to repair the leak or remove blebs (air-filled sacs) on the lung surface.

How long does it take to recover from a pneumothorax? Recovery time varies depending on the severity and treatment method. Small pneumothoraces may resolve in a few days, while those requiring chest tube placement may take 1-2 weeks. Full recovery can take several weeks to months.

Preventing Recurrence and Long-term Management

After experiencing a pneumothorax, preventing recurrence becomes a priority. Several strategies can help reduce the risk of future episodes:

• Smoking cessation: Quitting smoking is crucial, as it significantly increases the risk of pneumothorax
• Avoiding air travel: Patients are typically advised to avoid air travel for at least one week after full lung re-expansion
• Scuba diving restrictions: Most doctors recommend permanently avoiding scuba diving due to the high risk of recurrence
• Regular follow-ups: Scheduled check-ups with a pulmonologist can help monitor lung health and address any concerns
• Lifestyle modifications: Engaging in gentle exercises and maintaining a healthy weight can support overall lung health

Can pneumothorax be completely prevented? While it’s not always possible to prevent a first occurrence, especially in cases of spontaneous pneumothorax, following medical advice and making lifestyle changes can significantly reduce the risk of recurrence.

Living with Pneumothorax: Impact on Quality of Life

Experiencing a pneumothorax can have both short-term and long-term effects on an individual’s quality of life. Understanding these impacts can help patients and their families better manage the condition:

Physical Limitations

During recovery and in the weeks following a pneumothorax, patients may experience:

• Reduced lung capacity and exercise tolerance
• Lingering chest discomfort or pain
• Fatigue and weakness

Emotional and Psychological Effects

The experience of a collapsed lung can also have psychological impacts:

• Anxiety about recurrence
• Fear of engaging in certain activities
• Depression related to physical limitations or lifestyle changes

Occupational Considerations

Depending on the severity and recurrence risk, some patients may need to consider occupational changes, particularly if their work involves:

• Heavy lifting or strenuous physical activity
• Exposure to significant changes in air pressure (e.g., aviation, deep-sea diving)
• Environments with poor air quality

How can patients cope with the psychological impact of pneumothorax? Support groups, counseling, and open communication with healthcare providers can be valuable resources for managing the emotional aspects of living with this condition.

Advances in Pneumothorax Research and Treatment

The field of pneumothorax management is continually evolving, with new research and technological advancements improving diagnosis, treatment, and prevention strategies:

Improved Imaging Techniques

Advancements in imaging technology, such as low-dose CT scans and portable ultrasound devices, are enhancing the accuracy and speed of pneumothorax diagnosis, particularly in emergency settings.

Minimally Invasive Treatments

Research into less invasive treatment options is ongoing, including:

• Endobronchial valves for persistent air leaks
• Autologous blood patch pleurodesis for recurrent pneumothoraces
• Improved surgical techniques with smaller incisions and faster recovery times

Genetic Research

Studies exploring the genetic factors contributing to spontaneous pneumothorax may lead to better prevention strategies and personalized treatment approaches in the future.

Artificial Intelligence in Diagnosis

The integration of AI algorithms in radiological imaging analysis shows promise in improving the speed and accuracy of pneumothorax detection, particularly in busy clinical settings.

What potential breakthroughs in pneumothorax treatment are on the horizon? While specific breakthroughs are difficult to predict, ongoing research in areas such as tissue engineering for lung repair and targeted gene therapies offer exciting possibilities for future treatment options.

In conclusion, understanding pneumothorax – from its causes and symptoms to diagnosis and treatment – is crucial for both patients and healthcare providers. While a collapsed lung can be a frightening experience, advances in medical knowledge and technology continue to improve outcomes and quality of life for those affected by this condition. As research progresses, we can look forward to even more effective strategies for managing and preventing pneumothorax in the future.

Symptoms, Diagnosis and Treating Pneumothorax

What are the Symptoms of Pneumothorax?

Symptoms normally come on almost immediately and commonly begin with chest pain. Other signals that the problem may be a collapsed lung are:

• Sharp, stabbing chest pain that worsens when trying to breath in
• Shortness of breath
• Bluish skin caused by a lack of oxygen
• Fatigue
• Rapid breathing and heartbeat
• A dry, hacking cough

How Pneumothorax is Diagnosed

During an initial physical exam, your doctor will want to specifically listen to your chest through a stethoscope. As you breathe, they may tap your chest and listen for hollow sounds. Since higher than normal levels of carbon dioxide and low levels of oxygen can be indicators, your doctor may suggest an arterial blood gas test to test these levels. To get a definite diagnosis, your doctor will most likely need to order an imaging test such as a chest X-ray, an ultrasound or CT scan.

How to Treat a Collapsed Lung

The goal of treatment is to relieve the pressure on the lung and allow it to re-inflate. The type of treatment selected will depend on the cause and severity of the collapse, and on the patient’s overall health.

For a minor pneumothorax, your doctor may simply keep an eye on you, as the lung may re-inflate on its own, usually over the course of several weeks. In these cases, your doctor may suggest supplemental oxygen and require you to schedule follow-up visits to ensure that the problem does not worsen.

For more serious pneumothorax, a needle aspiration or chest tube can be inserted into the chest cavity to remove the excess air. During a needle aspiration, a needle attached to a syringe is inserted between the ribs into the air-filled space that is pressing on the collapsed lung and is used to suction out the excess air. A chest tube involves a similar insertion that involves a one-way valve device that continuously removes air until the lung re-inflates. The tube may need to stay in for a few hours, or even a few days, to ensure that the lung does not collapse again.

In cases that involve an accident, or repeated collapsed lungs, the next step is a non-surgical repair of the leak. This can be done in several ways and is sometimes called pleurodesis.

In the most extreme cases, surgery may be necessary to close the leak or remove the collapsed portion of the lung.

Preventing Pneumothorax

Anyone who suffers from a collapsed lung will have to monitor their health to make sure it doesn’t happen again. Avoiding air travel for the first week after a collapse is often suggested. Diving puts patients at high risk, so most doctors suggest permanently avoiding it. Also, people who smoke are at increased risk of a pneumothorax, so quitting is highly recommended.

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Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.

Page last updated: April 10, 2020

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Collapsed Lung (Pneumothorax)

Condition Basics

What is a pneumothorax?

A collapsed lung (pneumothorax) is a buildup of air in the space between the lung and the chest wall (pleural space). As the amount of air in this space increases, the pressure against the lung causes the lung to collapse. This prevents your lung from expanding the right way when you try to breathe in. You will likely have shortness of breath and chest pain.

A pneumothorax may become deadly if the pressure in your chest prevents the lungs from getting enough oxygen into the blood.

What causes it?

A pneumothorax is often caused by an injury to the chest. These can be things like a broken rib or puncture wound. It may also occur suddenly without an injury.

A pneumothorax can result from damage to the lungs. This can be caused by conditions such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, and pneumonia. A pneumothorax can also occur in people who don’t have lung disease. This happens when an air-filled blister (bleb) on the lung ruptures and releases air into the pleural space.

What are the symptoms?

Symptoms depend on the size of the pneumothorax. In minor cases, you may not realize you have a pneumothorax. In more severe cases, symptoms will develop rapidly and may lead to shock.

Symptoms may include:

• Shortness of breath (dyspnea). This may be mild to severe, depending on how much of the lung is collapsed.
• Sudden, severe, and sharp chest pain on the same side as the collapsed lung.

Symptoms may become worse with altitude changes (such as flying in an airplane or going underground or underwater).

How is it diagnosed?

A pneumothorax usually is diagnosed through a physical exam and a chest X-ray. Your doctor may also do blood tests to measure the level of oxygen in your blood. You may need a CT scan or ultrasound to diagnose the severity of your condition. These tests will also help the doctor plan your treatment.

How is a pneumothorax treated?

Treatment can depend on the cause and severity of the pneumothorax. Treatment can also depend on whether the pneumothorax has returned. Some people stay in the hospital for treatment. A minor pneumothorax may heal with rest, but you will need to be checked by your doctor. In some cases, oxygen may be given (through a mask). More serious cases are treated by placing a needle or a chest tube into the chest cavity. Both of these treatments relieve the pressure on the lung and allow it to expand again. Sometimes surgery is done.

Will it return?

If you have had one pneumothorax, you have an increased risk for another. People who smoke cigarettes are more likely to develop a pneumothorax than those who don’t. If you smoke, quitting smoking can reduce your risk of another pneumothorax.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

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Pulmonologist explained why singing can burst lungs – Gazeta.Ru

Pulmonologist explained why singing can burst lungs – Gazeta.Ru | News

02 December 2021, 17:57

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Singing can cause pneumothorax – the accumulation of air or gases in the pleural cavity of the lungs, which leads to the collapse of the organ – due to a hereditary pathology of the respiratory organs in humans, this was told by Channel Five pulmonologist, doctor of medical sciences Alexander Karabinenko.

The doctor spoke about bullous emphysema, a hereditary pathology of the respiratory system. It is expressed in the fact that air bubbles [bulls] are produced in the lungs, which, with tension or an increase in internal pressure, can burst. As a result, the released air enters the pleural cavity and provokes the aforementioned pneumothorax.

The doctor emphasized that not all singers are susceptible to this disease, namely those who suffer from this pathology, since the disease manifests itself due to pressure inside the lungs as a result of active singing, and not because of the pitch of the notes taken. A similar diagnosis, as Karabinenko explained, can be given to weightlifters and glassblowers.

The disease is usually accompanied by general malaise, shortness of breath, increasing chest pain and a drop in blood pressure. In such a situation, the doctor concluded, urgent hospitalization of the patient is necessary.

“If air is poured out in a large volume, this can lead to a serious condition – if the air is not removed, the patient may die from increasing pulmonary heart failure. If the volume of air is small, then it can be easily removed from the pleura by special methods,” the pulmonologist explained.

According to him, in any case, you need to see a doctor. At the same time, you can go to a regular clinic, and not to an appointment specifically with a pulmonologist. The patient should be referred for a chest x-ray and a decision made to remove excess air if its volume exceeds 500 milliliters.

It was previously reported that , a Chinese resident, was admitted to the hospital after hitting too high a note in karaoke. The doctors sent the patient for an x-ray and, thanks to the picture, they learned that he had the aforementioned lung collapse.

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Collapse.

What is Collapse?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Collapse is an acutely developing vascular insufficiency, accompanied by a decrease in the tone of the bloodstream and a relative decrease in BCC. It is manifested by a sharp deterioration in the condition, dizziness, tachycardia, hypotension. In severe cases, loss of consciousness is possible. It is diagnosed on the basis of clinical data and the results of tonometry according to the Korotkov method. Specific treatment includes cordiamine or caffeine under the skin, crystalloid infusions, recumbency with a raised leg end. After the restoration of consciousness, hospitalization is indicated for differential diagnosis and determination of the causes of the pathological condition.

ICD-10

R55 Fainting [syncope] and collapse

• Causes of collapse
• Pathogenesis
• Classification
• Collapse symptoms
• Complications
• Diagnostics
• Emergency
• Prognosis and prevention
• Prices for treatment

General

Collaptoid state (vascular insufficiency) is a pathology that suddenly occurs against the background of the presence of chronic or acute diseases of the cardiovascular system and other diseases. It is more often diagnosed in patients prone to hypotension, with myocardial infarction, total blockade of intracardiac conduction, ventricular arrhythmias. By pathogenesis and clinical signs, it resembles shock. It differs from it in the absence of characteristic pathophysiological phenomena in the initial stages – changes in pH, a significant deterioration in tissue perfusion and disruption of the internal organs are not detected. The duration of the collapse usually does not exceed 1 hour, the state of shock may persist for a longer period of time.

Collapse

Causes of collapse

Regulation of vascular tone is carried out using three mechanisms: local, humoral and nervous. The nervous mechanism consists in stimulation of the vessel wall by the fibers of the sympathetic and parasympathetic nervous systems. The humoral method is implemented due to sodium and calcium ions, vasopressor hormones (adrenaline, vasopressin, aldosterone). Local regulation involves the appearance of ectopic foci directly in the vascular wall, the cells of which have the ability to generate their own electrical impulses. The circulatory network of skeletal muscles is regulated predominantly in a nervous way, therefore, the collapse can be caused by any condition in which the activity of the vasomotor center of the brain is suppressed. The main etiological factors are:

• Infectious processes. Severe infections accompanied by severe intoxication lead to the development of vascular insufficiency. Most often, collapse occurs with lobar pneumonia, sepsis, peritonitis, meningitis and meningoencephalitis, typhoid fever, focal inflammatory diseases of the central nervous system (brain abscess).
• Exogenous intoxications. Pathology is detected in case of poisoning with organophosphorus compounds, carbon monoxide, drugs that can affect vascular tone (clopheline, capoten, ebrantil). In addition, collapse can develop under the influence of drugs for local anesthesia when they are administered epidurally or epidurally.
• Heart diseases. The most common cause is acute myocardial infarction. Collaptoid conditions can also be detected against the background of malformations of the heart, a decrease in myocardial contractility, tachy- or bradyarrhythmia, dysfunction of the sinoatrial node (pacemaker), failures of the atrioventricular connection (AV blockade of the 3rd degree) with discoordination of the work of the atria and ventricles.
• Injuries. The main cause of vascular insufficiency in injuries is a large amount of blood loss. In this case, there is not a relative, but an actual decrease in BCC due to the physical loss of fluid. In the absence of profuse hemorrhage, a drop in vascular tone becomes a response to severe pain, which is more common in children and patients with high tactile sensitivity.

Pathogenesis

The pathogenesis of collaptoid states is based on a pronounced discrepancy between the throughput of the vascular network and the BCC. Expanded arteries do not create the necessary resistance, which leads to a sharp decrease in blood pressure. The phenomenon can occur with toxic damage to the vasomotor center, disruption of the receptor apparatus of large arteries and veins, inability of the heart to provide the necessary volume of blood ejection, insufficient amount of fluid in the circulatory system. A drop in blood pressure leads to a weakening of gas perfusion in tissues, insufficient oxygen supply to cells, ischemia of the brain and internal organs due to a mismatch between the metabolic needs of the body and the level of its supply with O2.

Classification

The division is made according to the etiological principle. There are 14 varieties of collapse: infectious-toxic, pancreatic, cardiogenic, hemorrhagic, etc. Since the same first aid measures are performed for all types of pathology, such a classification does not have significant practical significance. The systematization by stages of development is more relevant:

• sympathetic stage. Compensatory reactions are expressed. There is a spasm of small capillaries, centralization of blood circulation, the release of catecholamines. Blood pressure is kept within normal limits or rises slightly. The duration does not exceed a few minutes, so the pathology is rarely diagnosed at this stage.
• vagotonic stage. There is a partial decompensation, the expansion of arterioles and arteriovenous anastomoses is revealed. Blood is deposited in the capillary bed. There are signs of hypotension, the blood supply to the skeletal muscles worsens. The duration of the period is 5-15 minutes, depending on the compensatory capabilities of the body.
• paralytic stage. Complete decompensation of the state associated with the depletion of the mechanisms of regulation of blood circulation. There is a passive expansion of capillaries, visible signs of vascular congestion on the skin, depression of consciousness. Hypoxia of the organs of the central nervous system develops. If left untreated, heart failure and death can occur.

Collapse symptoms

The clinical picture that develops in acute vascular insufficiency changes as the disease progresses. Sympathotonic stage is characterized by psychomotor agitation, anxiety, increased muscle tone. The patient is active, but not fully aware of his actions, cannot sit or lie still even at the request of the medical staff, tosses about in bed. The skin is pale or marble, the extremities are cold, there is an increase in the heart rate.

At the vagotonic stage, the patient is inhibited. He answers questions slowly, in monosyllables, does not understand the essence of the speech addressed to him. Muscle tone decreases, physical activity disappears. The skin is pale or gray-cyanotic, earlobes, lips, mucous membranes acquire a bluish tint. Blood pressure moderately decreases, bradycardia or tachycardia occurs. The pulse is weakly determined, has insufficient filling and tension. Glomerular filtration is reduced, which causes oliguria. Breathing is noisy, rapid. Nausea, dizziness, vomiting, severe weakness join.

With paralytic collapse, loss of consciousness occurs, skin (plantar, abdominal) and bulbar (palatine, swallowing) reflexes disappear. The skin is covered with blue-purple spots, which indicates capillary stagnation. Respiration is rare, periodic according to the Cheyne-Stokes type. Heart rate slows down to 40-50 beats per minute or less. The pulse is thready, blood pressure drops to critical numbers. Early stages are sometimes stopped without medical intervention, due to compensatory-adaptive reactions. At the final stage of the pathology, an independent reduction of symptoms is not observed.

Complications

The main danger of collapse is considered to be a violation of blood flow in the brain with the development of ischemia. With a long course of the disease, this causes dementia, a dysfunction of the internal organs innervated by the central nervous system. When vomiting against the background of unconsciousness or stupor, there is a risk of inhalation of gastric contents. Hydrochloric acid in the respiratory tract causes burns of the trachea, bronchi, lungs. Aspiration pneumonia occurs, which is difficult to treat. The lack of immediate assistance at the third stage leads to the formation of pronounced metabolic disorders, disruption of the receptor systems and death of the patient. A complication of successful resuscitation in such cases is post-resuscitation disease.

Diagnostics

Collapse is diagnosed by a medical worker who was the first to arrive at the scene: in the ICU – an anesthesiologist-resuscitator, in a therapeutic hospital – a therapist (cardiologist, gastroenterologist, nephrologist, etc. ), in the surgical department – a surgeon. If the pathology has developed outside the health facility, a preliminary diagnosis is made by the ambulance team according to the examination. Additional methods are prescribed in a medical institution for the purpose of differential diagnosis. Collapse is distinguished from coma of any etiology, fainting, shock. The following methods are used:

• Physical. The doctor detects clinical signs of hypotension, absence or depression of consciousness, which persist for 2-5 minutes or more. A shorter time of unconsciousness with its subsequent recovery is characteristic of fainting. According to the results of tonometry, blood pressure is below 90/50. There are no signs of head trauma, including focal symptoms.
• Hardware. It is performed after stabilization of hemodynamics to determine the causes of collapse. CT of the head (tumors, focal inflammatory processes), CT of the abdominal cavity (pancreatitis, cholelithiasis, mechanical damage) is indicated. In the presence of coronary pain, ultrasound of the heart is performed (expansion of chambers, congenital malformations), electrocardiography (signs of ischemia, myocardial infarction). Suspicion of vascular disorders is confirmed using color Doppler imaging, which allows to establish the degree of patency of the arteries and venous vessels.
• Laboratory. In the course of a laboratory examination, the level of sugar in the blood is determined to exclude hypo- or hyperglycemia. A decrease in the concentration of hemoglobin is found. Inflammatory processes lead to an increase in ESR, pronounced leukocytosis, and sometimes an increase in the concentration of C-reactive protein. With prolonged hypotension, a shift in the pH to the acid side, a decrease in the concentration of electrolytes in the plasma, is possible.

Emergency

The patient in a state of collapse is placed on a horizontal surface with legs slightly elevated. When vomiting, the head is turned so that the discharge flows freely outward, and does not enter the respiratory tract. The VRT is cleaned with two fingers wrapped in a gauze swab or a clean cloth. The list of further therapeutic measures depends on the stage of collapse:

• Sympathotonic stage. Showing procedures aimed at stopping vascular spasm. Intramuscularly injected papaverine, dibazol, but-shpu. To prevent hypotension and stabilize hemodynamics, steroid hormones (dexamethasone, prednisolone) are used. It is recommended to install a peripheral venous catheter, control blood pressure and the general condition of the patient.
• Vagotonia and paralytic stage. To restore the bcc, infusions of crystalloid solutions are carried out, to which, if necessary, cardiotonic agents are added. To prevent aspiration of gastric contents at the prehospital stage, an air duct or a laryngeal mask is installed in the patient. Glucocorticosteroids are administered once at a dose corresponding to the age of the patient, cordiamine, caffeine. Pathological breathing is an indication for transfer to mechanical ventilation.

Hospitalization is carried out in the intensive care unit of the nearest specialized medical facility. In the hospital, medical measures continue, an examination is prescribed, during which the causes of the pathology are determined. Provides support for vital body functions: respiration, cardiac activity, kidney function. Therapy aimed at eliminating the causes of a collaptoid attack is being carried out.

Prognosis and prevention

Since the pathology develops with decompensation of severe diseases, the prognosis is often unfavorable. Directly vascular insufficiency is relatively easy to stop, however, while maintaining its root cause, attacks occur again. Intractable collapse leads to the death of the patient. Prevention consists in the timely treatment of pathologies that can lead to a sharp drop in vascular tone. Properly selected therapy for heart disease, timely prescription of antibiotics for bacterial infections, complete detoxification for poisoning and hemostasis for injuries can prevent collapse in 90% of cases.