How does a pneumothorax occur. What are the primary symptoms of a collapsed lung. Can a collapsed lung be life-threatening. What causes a pneumothorax. How is a collapsed lung diagnosed and treated. When should you seek medical attention for suspected pneumothorax. What precautions should be taken after recovering from a collapsed lung.

Understanding Pneumothorax: The Basics of a Collapsed Lung

A pneumothorax, commonly known as a collapsed lung, is a condition where air escapes from the lung and accumulates in the space between the lung and chest wall. This buildup of air exerts pressure on the lung, preventing it from expanding normally during inhalation. While rare, pneumothorax can be a serious and potentially life-threatening condition that requires immediate medical attention.

What exactly happens during a pneumothorax?

During a pneumothorax, the escaped air creates a pocket of pressure outside the lung, causing it to partially or fully collapse. This collapse impairs the lung’s ability to function properly, leading to breathing difficulties and other symptoms. The severity of the condition depends on the amount of air that has escaped and the resulting degree of lung collapse.

Recognizing the Signs and Symptoms of a Collapsed Lung

Identifying the symptoms of a pneumothorax is crucial for seeking timely medical care. The signs can vary in intensity depending on the extent of the lung collapse, but they often develop suddenly.

What are the primary symptoms of a collapsed lung?

• Sudden, sharp chest pain that worsens with breathing or coughing
• Shortness of breath or difficulty breathing
• Rapid heart rate
• Chest tightness
• Dry, hacking cough
• Bluish skin color (cyanosis) due to lack of oxygen
• Fatigue

In some cases, particularly with small pneumothoraces, symptoms may be mild or even absent. However, it’s important to note that even a small pneumothorax can potentially progress and become more serious if left untreated.

Common Causes and Risk Factors for Pneumothorax

Understanding the causes of pneumothorax can help in prevention and early detection. There are several ways in which a lung can collapse, ranging from traumatic injuries to underlying medical conditions.

What are the primary causes of a collapsed lung?

1. Blunt chest trauma: This is the leading cause of pneumothorax, often resulting from car accidents, falls, or sports injuries.
2. Penetrating chest injuries: Stab wounds, gunshot wounds, or other puncture injuries can directly damage the lung.
3. Medical procedures: Certain medical interventions, such as lung biopsies or the insertion of central lines, can sometimes lead to pneumothorax as a complication.
4. Lung disease: Conditions like chronic obstructive pulmonary disease (COPD), cystic fibrosis, or lung cancer can increase the risk of spontaneous pneumothorax.
5. Spontaneous pneumothorax: This occurs without any apparent cause, typically in tall, thin young adults, especially males.

It’s worth noting that smoking significantly increases the risk of spontaneous pneumothorax, as it weakens lung tissue over time.

Diagnosing a Collapsed Lung: Medical Evaluation and Imaging

Prompt and accurate diagnosis of pneumothorax is essential for effective treatment. Healthcare providers use a combination of physical examination and imaging studies to confirm the condition.

How is a collapsed lung diagnosed?

• Physical examination: A doctor will listen to your breathing with a stethoscope and may notice decreased breath sounds on the affected side.
• Chest X-ray: This is the primary diagnostic tool, revealing the presence and extent of the pneumothorax.
• CT scan: For more detailed imaging, especially in complex cases.
• Ultrasound: Sometimes used in emergency settings for rapid assessment.

In some cases, particularly with tension pneumothorax (a severe form that can be life-threatening), diagnosis may be made clinically based on symptoms and physical examination alone, with treatment initiated immediately before imaging can be performed.

Treatment Approaches for Pneumothorax: From Conservative Management to Surgery

The treatment of pneumothorax depends on its size, severity, and underlying cause. The primary goal is to remove the excess air from the pleural space and allow the lung to re-expand.

What are the main treatment options for a collapsed lung?

1. Observation: Small, uncomplicated pneumothoraces may resolve on their own with careful monitoring.
2. Oxygen therapy: Breathing high-concentration oxygen can help the body absorb the excess air more quickly.
3. Needle aspiration: A needle is inserted into the chest cavity to remove the excess air.
4. Chest tube insertion: A tube is placed between the ribs to continuously drain air and allow the lung to re-expand.
5. Pleurodesis: A procedure to create adhesions between the lung and chest wall, preventing future air leaks.
6. Surgery: In recurrent or complicated cases, surgical intervention may be necessary to repair the lung and prevent future collapses.

The choice of treatment depends on various factors, including the size of the pneumothorax, the patient’s overall health, and whether it’s a first-time occurrence or a recurrent problem.

Recovery and Aftercare: Ensuring Proper Healing Post-Pneumothorax

Recovery from a pneumothorax requires careful attention to aftercare instructions to promote healing and prevent recurrence.

What precautions should be taken after recovering from a collapsed lung?

• Avoid air travel for at least 1-2 weeks after full resolution of the pneumothorax.
• Refrain from scuba diving, unless cleared by a specialist, as the risk of recurrence may be higher.
• Quit smoking, if applicable, as it significantly increases the risk of recurrence.
• Avoid strenuous activities or contact sports for a period recommended by your doctor.
• Attend all follow-up appointments and imaging studies as scheduled.
• Be aware of symptoms that could indicate a recurrence and seek prompt medical attention if they occur.

It’s important to note that while most people recover fully from a pneumothorax, there is a risk of recurrence, especially in cases of spontaneous pneumothorax. Your healthcare provider will discuss any long-term precautions or lifestyle modifications that may be necessary based on your individual case.

Prevention Strategies: Minimizing the Risk of Pneumothorax

While not all cases of pneumothorax can be prevented, there are steps individuals can take to reduce their risk, especially if they have known risk factors.

How can one reduce the risk of developing a pneumothorax?

• Quit smoking and avoid exposure to secondhand smoke.
• Wear appropriate protective gear during contact sports or activities with a risk of chest trauma.
• Follow safety guidelines and use proper equipment when working in environments with a risk of lung injury.
• Manage underlying lung conditions effectively, following your doctor’s treatment plan.
• Be cautious during air travel or high-altitude activities if you have a history of lung problems.
• Maintain overall lung health through regular exercise and avoiding air pollution when possible.

For individuals with a history of pneumothorax or those at higher risk due to lung conditions, additional preventive measures may be recommended by healthcare providers. These might include lifestyle modifications or, in some cases, preventive surgical procedures for those with recurrent pneumothoraces.

Living with Pneumothorax: Long-Term Considerations and Quality of Life

For most individuals, a single episode of pneumothorax does not lead to long-term health issues once properly treated. However, those who experience recurrent pneumothoraces or have underlying lung conditions may need to make some adjustments to their lifestyle.

What are the long-term implications of having experienced a pneumothorax?

• Increased awareness of lung health and symptoms
• Regular follow-up with pulmonologists or thoracic specialists
• Potential limitations on certain high-risk activities or professions
• Psychological impact, including anxiety about recurrence
• Importance of maintaining overall health and avoiding risk factors

It’s crucial for individuals who have experienced a pneumothorax to work closely with their healthcare providers to develop a personalized plan for long-term lung health. This may include regular check-ups, lifestyle modifications, and strategies for managing any associated anxiety or concerns.

In conclusion, while a pneumothorax can be a frightening experience, understanding the condition, recognizing its symptoms, and knowing when to seek medical attention can significantly improve outcomes. With proper treatment and aftercare, most individuals can recover fully and return to their normal activities. However, ongoing awareness and preventive measures remain important for maintaining long-term lung health and reducing the risk of recurrence.

Know the Signs of a Collapsed Lung

You may have heard of a collapsed lung, but what exactly does that mean, and how do you treat it? 

A collapsed lung, or pneumothorax, happens when air escapes from your lung and fills the space between the lung and chest wall. The lung is then not able to expand normally when you take a breath. The condition is rare but could be life-threatening, so you should seek immediate care.

Symptoms of a collapsed lung include:

• Dull, steady ache in the chest
• Pain upon inhaling
• Shortness of breath
• Chest tightness
• The sensation that you can’t draw breath
• Face turning blue due to lack of oxygen
• Very fast heartbeat

What Causes a Collapsed Lung?

Impact with Blunt Object. This is the leading cause of a collapsed lung. It can happen when playing sports where you might collide with a ball or person. A car crash can also involve an impact to the chest wherein this injury could occur.

Puncture. Any penetrating wound to the chest can puncture the lung. This could be something violent, like a knife or stab wound. It could also be the result of vigorous play, such as a pencil stabbing. An aerosol can exploding could also cause a collapsed lung.

Disease. Diseases such as emphysema and COPD can lead to a collapsed lung. Certain infections, such as pneumonia, can be the culprit, too.

Spontaneous pneumothorax. Very tall and typically very thin male young adults are especially prone. For these people, the pneumothorax can just occur; you don’t need to be hit in the chest or have other trauma for it to happen.    

Hospital procedures. In the hospital, some medical procedures, such as the insertion of a chemotherapy port to your chest, can also sometimes damage your lung.

What To Do Immediately After Injury

The most pressing concern is to make sure oxygen is flowing. Emergency services should be called immediately, and you will be administered oxygen as you are transported to a hospital.

When oxygen escapes from the lungs, they can’t function fully and properly. Supplying oxygen keeps the lungs working and helps replace some of the missing air. Psychologically, the sooner your breathing returns to a more normalized state, the sooner your body receives the signal to relax. Supplied oxygen can help the pneumothorax get smaller too. 

How a Collapsed Lung Is Treated

Treatment is determined by how much of the lung is collapsed. If just a small portion is affected, your doctor may admit you to the hospital for observation. If you have a tiny wound, it can easily seal over.

If the affected area is larger, your doctor will evacuate the air that has escaped from the lung and is gathering in the chest cavity. Each time air gets pushed out from the lung, it is then trapped and pushing against the lung. Picture your lung as a balloon, and in this case, it’s pushed against a wall. This misplaced air can also exert pressure on the heart, which is another reason to address the problem quickly.

Your doctor will explore all nonsurgical options. One of the first steps is to place a small chest tube with a suction device to evacuate the air from outside the lung.

A second course of treatment might be a patch through which your own blood can be inserted to seal the injury. Alternatively, another substance may be inserted through the chest tube to intentionally irritate the lung lining, causing it to stick together and seal up.

If the affected lung area doesn’t seal with these measures, your doctor can perform a video-assisted surgery to find where the air is escaping and repair it.

Your doctor will make the most conservative treatment choice possible, escalating only when necessary.

What To Do After Treatment

After the wound has been treated, it’s important that, for the next two to four weeks, you avoid:

• Flying on airplanes
• Scuba diving
• Playing a wind instrument
• Playing contact sports or participating in anything where a chest hit might occur

Once the injury has fully healed, you’re safe to resume these activities and your normal lifestyle.

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Collapsed lung (pneumothorax) Information | Mount Sinai

Air around the lung; Air outside the lung; Pneumothorax dropped lung; Spontaneous pneumothorax

A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung between the lung and chest wall. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath.

The medical name of this condition is pneumothorax.

The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

Aortic rupture (a tear in the aorta, which is the major artery coming from the heart) can be seen on a chest X-ray. In this case, it was caused by a traumatic perforation of the thoracic aorta. This is how the X-ray appears when the chest is full of blood (right-sided hemothorax) seen here as cloudiness on the left side of the picture.

Pneumothorax occurs when air leaks from inside of the lung to the space between the lung and the chest wall. The lung then collapses. The dark side of the chest (right side of the picture) is filled with air that is outside of the lung tissue.

Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

The pleural cavity is the space between the layers of the membrane lining the lung (pleura) and the chest cavity.

The lungs are paired organs that lie in the thoracic cavity. The lungs extract oxygen from inhaled air and transport the oxygen to the blood. Surrounding the lungs is a very thin space called the pleural space. The pleural space is usually extremely thin, and filled with a small amount of fluid.

Causes

Collapsed lung can be caused by an injury to the lung. Injuries can include a gunshot or knife wound to the chest, rib fracture, or certain medical procedures.

In some cases, a collapsed lung is caused by air blisters of the lung (blebs) that break open, sending air into the space around the lung. This can result from air pressure changes such as when scuba diving or traveling to a high altitude.

Tall, thin people and smokers are more at risk for a collapsed lung.

Lung diseases can also increase the chance of getting a collapsed lung. These include:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• Tuberculosis
• Whooping cough

In some cases, a collapsed lung occurs without any cause. This is called a spontaneous collapsed lung or spontaneous pneumothorax.

Symptoms

Common symptoms of a collapsed lung include:

• Sharp chest or shoulder pain, made worse by a deep breath or a cough
• Shortness of breath
• Nasal flaring (from shortness of breath)

A larger pneumothorax causes more severe symptoms, including:

• Bluish color of the skin due to lack of oxygen
• Chest tightness
• Lightheadedness and near fainting
• Easy fatigue
• Abnormal breathing patterns or increased effort of breathing
• Rapid heart rate
• Shock and collapse

Exams and Tests

The health care provider will listen to your breathing with a stethoscope. If you have a collapsed lung, there are decreased breath sounds or no breath sounds on the affected side. You may also have low blood pressure.

Tests that may be ordered include:

• Chest x-ray
• Arterial blood gases and other blood tests
• CT scan if other injuries or conditions are suspected
• Electrocardiogram (ECG)

Treatment

A small pneumothorax may go away on its own over time. You may only need oxygen treatment and rest.

The provider may use a needle to allow the air to escape from around the lung so it can expand more fully. You may be allowed to go home if you live near the hospital.

If you have a large pneumothorax, a chest tube will be placed between the ribs into the space around the lungs to help drain the air and allow the lung to re-expand. The chest tube may be left in place for several days and you may need to stay in the hospital. If a small chest tube or flutter valve is used, you may be able to go home. You will need to return to the hospital to have the tube or valve removed.

Some people with a collapsed lung need extra oxygen.

Lung surgery may be needed to treat collapsed lung or to prevent future episodes. The area where the leak occurred may be repaired. Sometimes, a special chemical is placed into the area of the collapsed lung. This chemical causes a scar to form. This procedure is called pleurodesis.

Outlook (Prognosis)

If you have a spontaneous collapsed lung, you are more likely to have another one in the future if you:

• Are tall and thin
• Continue to smoke
• Have had two collapsed lung episodes in the past

How well you do after having a collapsed lung depends on what caused it.

Possible Complications

Complications may include any of the following:

• Another collapsed lung in the future
• Shock, if there are serious injuries or infection, severe inflammation, or fluid in the lung develops

When to Contact a Medical Professional

Contact your provider if you have symptoms of a collapsed lung, especially if you have had one before.

Prevention

There is no known way to prevent a collapsed lung. Following standard procedure can reduce the risk of a pneumothorax when scuba diving. You can decrease your risk by not smoking.

Hallifax R, Rahman NM. Pneumothorax. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel’s Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 110.

Peak DA. Scuba diving and dysbarism. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 131.

Raja AS. Thoracic trauma. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 37.

Last reviewed on: 1/2/2023

Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

There are more homeless planets in the Universe than usual

Planets for us are gas giants or solid worlds orbiting the parent star. And while the stars are leaving, the Milky Way is littered with hundreds of billions of such planets, including our own, the only and so far unique Earth. And each planet, in principle, has its own and also unique history of the birth and life of . Some of them are massive and bright, others are small and dim; some were born a couple of million years ago, others can compete with the age of the universe itself. But there is one common feature that we endow all these planets with: the solar system. As the Kepler mission and other searches for exoplanets have shown, if you want to find planets, just point your finger at a star and look around it: around it you will find one, but a whole system of planets.

Each planet in our solar system has its own history

Planets without stars

And yet – in addition to the stars and all the bodies that revolve around them – there must be a great many planets that are not tied to the central star at all: planets – outcasts. Scientists believe this is true anywhere in the universe, from small star clusters and interstellar space to the cores of giant galaxies. As far as we know, there are as many starless planets in space as there are stars themselves – and maybe more. It follows that for every point of light you see, there are many more massive points that you can’t see because they don’t emit visible light.

There are a huge number of starless planets in space.

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Through observations, we have discovered a number of possible candidates for rogue planets . “Candidate” is an important word; we cannot be sure that these planets are true, because we do not have a good technique for confirming this fact. Even with our best modern equipment, they are so difficult to detect that we must assume the existence of many more worlds than we have already found. But we have already found something and can draw conclusions. Where do these alien planets come from?

One of the most convincing sources of all these planets is near us, and we cherish it very much.

A protoplanetary disk around a star

We know how solar systems form: after gravitational collapse creates a region of space in which fusion ignites, a protoplanetary disk gathers around the central star. Gravitational perturbations regularly appear in this disk, drawing more and more matter from its surroundings, while the heat of the newly formed central star slowly blows the lightest gas into the interstellar medium. Over time, gravitational perturbations develop into asteroids, solid planets and gas giants.

But the fact is that these worlds not only revolve around their star, but also gravitationally pull each other together. Over time, these planets migrate to the most stable configurations they can achieve: the most massive worlds take their most stable places, often sacrificing other smaller worlds. What happens to the “losers” in the cosmic battle for planetary advantage? They are absorbed in the process of merging, fall into the Sun or are ejected from the solar system into interstellar space.

Solar system simulations

Recent simulations have shown that for every planet-rich solar system like our own (with gas giants), at least one gas giant will be ejected into the interstellar medium, where it will be doomed to wander the galaxy by a wandering planet – an outcast. At the same time, the number of smaller solid worlds thrown out of the system can reach 5-10. This, in principle, is the largest source of rogue planets, and there are probably hundreds of billions of them in our own galaxy.

It is particularly amusing that when scientists make theoretical calculations, ejected planets from young solar systems turn out to be half the expected number of rogue planets. Where do they come from then? To understand where most starless planets come from, we need to take a broader look at one time: not only when our solar system formed, but also at the cluster of stars (and star systems) that formed at the same time.

The formation of stars and galaxies gives us an understanding of where rogue planets come from

Star clusters form from the slow collapse of cold gas, mostly hydrogen, and usually originate in a pre-existing galaxy. Deep in the collapsing clouds gravitational instabilities form and the first, most massive instabilities attract more and more matter. When enough matter is collected in a small region of space and the density and temperature in the core become high enough, nuclear fusion begins and stars form.

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But not one star and star system is born, but many of them, because each cloud that collapses to form a new star contains enough material to form many stars. Along with this, something happens. The largest formed star is also the hottest and bluest, that is, it emits the most ionizing, ultraviolet radiation. And this star is starting one of the most active races to take his place in space.

If you look into the star-forming nebula, you can see two processes occurring simultaneously:

• Gravity is trying to pull matter in the direction of this young, growing gravitational overdensity
• Radiation burns out neutral gas and pushes it back into the interstellar medium

90 057

Who will win?

There are different types of stars

The answer depends on what counts as a victory. The largest gravitational superdensities form the largest, hottest, and bluest stars—but such stars are exceedingly rare. Smaller superdensities (still large) form other stars, but as the mass decreases, more and more of them become. That is why, when we look deep into a cluster of young stars, it is easy to see the brightest (blue or otherwise) stars, but they are greatly outnumbered by yellow (and red) stars with less mass.

Can planets grow

If it weren’t for the radiation that young stars emit, these dim, red and yellow stars would continue to grow, become more massive and brighter, would flare up more strongly. Stars (in the main sequence) come in different types of , from O stars (the hottest, biggest and bluest) to M stars (the smallest, coolest, reddest and low mass). And although the majority of stars – ¾ – are M-class stars, and less than 1% of all stars are O- or B-type stars, the total mass of the last two types of stars is comparable to the total mass of M-type stars. It takes about 250 M-class stars to match the mass of an O star.

Classification of stars

As it turns out, about 90% of the original gas and dust that was in this star-forming nebula is blown out into the interstellar medium and does not go into star formation. The most massive stars form faster and begin to blow material out of the nebula. In just a couple of million years, there is less and less material left, and new stars stop forming. The remaining gas with dust completely burn out.

And now the most interesting part. Not only M-class stars – with a mass between 8% and 40% of the Sun – represent the most common type of stars in the Universe. There’s a lot more to what could be M-class stars if the high-mass stars didn’t burn out the excess material.

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In other words, for every star formed, there are many more failed stars that simply did not reach critical mass: and there can be tens to hundreds of thousands of such stars for every star formed.

Just imagine: our own solar system contains hundreds or even thousands of objects that potentially fit the geophysical definition of a planet, but have been astronomically ruled out just by virtue of their orbital position. Now imagine that for every star like our Sun, there are hundreds of failed stars that simply haven’t gained enough mass to trigger fusion in the core. These are homeless planets – or rogue planets – which are much more than planets like ours, orbiting stars. Orphan planets may or may not have an atmosphere and are extremely difficult to detect, especially the smallest ones. But think about it: for every planet like ours in the galaxy, there could be up to 100,000 planets that not only don’t orbit the star now, but never did. Finding them is very difficult.

Rogue planets roam the vastness of space

So while we may have a few planets ejected from young solar systems, and even a handful of such worlds in a galaxy that hails from the solar system, the vast majority of all planets in the galaxy have never held onto stars . Rogue planets roam the galaxy, doomed to forever wandering in the darkness of and never know the warmth of their parent star. Their potential parents, perhaps, never even became stars. There could be a quadrillion of these wandering worlds in the galaxy that we haven’t even really begun to discover yet.

InScience

News

The kilonova explosion has an almost perfect spherical shape

By Anastasia Cherkesova Sat February 18, 2023

Albert Sneppen

Astronomers have discovered that the explosion that accompanies the collision of two neutron stars has a spherical shape. This discovery will help to understand the fundamental physics of the processes that occur in space, and even clarify the age of the universe. The study is published in the journal Nature.

When two neutron stars revolve around each other and then collide, gigantic explosions occur – kilones. As a result of the reactions that accompany these events, heavy chemical elements and, for example, black holes appear. For a long time, kilonovae remained a mystery. For the first time, scientists were able to obtain data on them only in 2017, when a kilonova explosion was recorded at a distance of 140 million light-years from us. Until now, scientists continue to investigate this event.

Previously, researchers believed that the kilonova explosion should be asymmetric and have a flattened shape. However, in reality, everything is not so at all. The 2017 kilonova explosion has an almost perfect ball shape. Scientists say that this is very strange.

“The most likely way to make an explosion spherical is if a huge amount of energy rushes out of the center of the explosion and flattens out a shape that would otherwise be asymmetric. Thus, the spherical shape tells us that, probably, a powerful release of energy occurred in the center of the collision, ”said Albert Sneppen from the Niels Bohr Institute.

When two neutron stars collide, they briefly merge into one supermassive neutron star. And then it collapses into a black hole. “Perhaps a kind of “magnetic bomb” is created at the moment when the star collapses into a black hole and the energy of the huge magnetic field of a hypermassive neutron star is released. This can lead to a more spherical distribution of matter during the explosion,” said Darach Watson of the Niels Bohr Institute.

However, this assumption misses another aspect of the researchers’ discovery. All the superheavy elements that the kilonova produces must scatter in different directions. Only now, scientists have discovered only lighter elements, evenly distributed in space.

Probably neutrinos. Scientists still don’t know much about this mysterious elementary particle, but one thing they know for sure: it can turn neutrons into protons and electrons and, therefore, create lighter elements.

In addition, the shape of the kilonovae must be known because it can be used to understand the age of the Universe. Such explosions can represent a new cosmic ruler: if they are bright and mostly spherical, and we know the distance at which they are from us, then using the “cosmic distance ladder” we can find out the expansion rate of the Universe, which will allow us to understand its age.