What are the symptoms of a collapsed lung. How is pneumothorax treated. What precautions should patients take after experiencing a pneumothorax. When should you seek urgent medical attention for pneumothorax complications.

Understanding Pneumothorax: What Is a Collapsed Lung?

Pneumothorax, commonly known as a collapsed lung, is a condition where air becomes trapped between the lung and the chest wall. This space, normally containing only a small amount of lubricating fluid, expands with the presence of air, causing the lung to collapse. Pneumothorax can occur spontaneously or as a result of trauma.

Spontaneous pneumothorax is more prevalent in certain groups:

• Men
• Smokers
• Individuals with underlying lung diseases

Common Symptoms of Pneumothorax

Recognizing the symptoms of pneumothorax is crucial for timely diagnosis and treatment. The most common symptoms include:

• Chest pain
• Shortness of breath
• Dry cough

These symptoms can vary in intensity depending on the size of the pneumothorax and the individual’s overall health condition.

Diagnosing and Treating Pneumothorax: Medical Approaches

The treatment of pneumothorax depends on several factors, including the cause, size, and severity of symptoms. Healthcare professionals consider the following when determining the appropriate treatment:

• The cause of the pneumothorax (spontaneous or traumatic)
• Presence of underlying lung disease
• Severity of symptoms
• Size of the pneumothorax

Treatment Options for Pneumothorax

Are all cases of pneumothorax treated the same way? No, treatment varies based on the specific circumstances of each case. Here are the primary treatment options:

1. Observation: Small pneumothoraces that don’t cause breathing difficulties may resolve without intervention.
2. Needle aspiration: For larger pneumothoraces, air may be removed using a needle. This procedure often allows patients to return home the same day.
3. Chest tube insertion: In cases of traumatic or very large pneumothoraces causing significant shortness of breath, a chest tube (chest drain) may be inserted. This typically requires a hospital stay.

Regardless of the treatment method, follow-up care is essential. Patients are usually advised to return to the clinic for a check-up 7-10 days after the initial treatment.

Managing Pain Associated with Pneumothorax

Pain management is an important aspect of pneumothorax treatment. Various pain relief options are available, depending on the severity of discomfort:

Over-the-Counter Pain Relievers

Which pain medications are commonly recommended for pneumothorax? Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are often the first line of defense:

• Paracetamol: The recommended adult dose is two 500 mg tablets, four times a day. It’s most effective when taken regularly for a few days rather than sporadically.
• NSAIDs: Medications like ibuprofen can be used alone or in combination with paracetamol. They help reduce pain, inflammation, and swelling.

Prescription Pain Medications

In cases of more severe pain, doctors may prescribe stronger painkillers:

• Codeine: Often prescribed in combination with paracetamol (e.g., co-codamol or co-dydramol). It’s crucial to avoid taking additional paracetamol when using these combination medications to prevent accidental overdose.
• Other prescription painkillers: If pain persists despite over-the-counter options, consult your general practitioner to discuss stronger pain relief options.

It’s important to note that patients should never exceed the recommended dosage of any pain medication. If pain is not adequately controlled with prescribed medications, consult a healthcare professional for further guidance.

Recovery and Aftercare: Navigating Life Post-Pneumothorax

Recovering from a pneumothorax requires careful attention to aftercare instructions and lifestyle modifications. Understanding these guidelines is crucial for a smooth recovery and preventing recurrence.

Air Travel Restrictions

Can patients with a history of pneumothorax travel by air? Air travel is subject to specific restrictions for those who have experienced a pneumothorax:

• Current pneumothorax: Flying is strictly prohibited due to the risk of tension pneumothorax, a life-threatening emergency caused by changes in air pressure.
• Recent pneumothorax: A chest X-ray is required to confirm resolution before flying. It’s recommended to wait at least 1 week after the confirming X-ray before air travel, or 2 weeks if the pneumothorax was caused by an injury.
• Long-term considerations: The risk of recurrence remains elevated for at least 1 year, especially for those with coexisting lung disease. Alternative forms of transport may be advisable during this period.

Scuba Diving Precautions

Is scuba diving safe after experiencing a pneumothorax? The risks associated with scuba diving vary depending on the type of pneumothorax:

• Spontaneous pneumothorax: Scuba diving is permanently contraindicated for individuals who have experienced a spontaneous pneumothorax.
• Traumatic pneumothorax: Diving may be possible after a traumatic pneumothorax, but further investigation is necessary. Consult with a healthcare professional for personalized advice.
• Professional considerations: For those whose occupation involves diving, surgical intervention to prevent recurrence may be an option to allow a return to diving activities.

Follow-Up Care and Monitoring: Ensuring Complete Recovery

Proper follow-up care is essential for monitoring recovery and detecting any potential complications. What does follow-up care typically involve?

• Clinic appointments: Patients are usually scheduled for a follow-up appointment to ensure the pneumothorax has resolved completely.
• Chest X-rays: Follow-up appointments typically include a chest X-ray to visually confirm the resolution of the pneumothorax.
• Ongoing monitoring: Healthcare providers may recommend regular check-ups, especially for patients with a higher risk of recurrence.

Recognizing Red Flags: When to Seek Urgent Medical Attention

While most cases of pneumothorax resolve with proper treatment and follow-up care, it’s crucial to be aware of potential complications. Patients should seek immediate medical attention if they experience any of the following symptoms:

• Increased shortness of breath
• Worsening chest pain
• Sudden onset of severe symptoms
• Fever or signs of infection
• Dizziness or fainting

These symptoms could indicate a recurrence of pneumothorax or the development of related complications that require prompt medical intervention.

Living with Pneumothorax: Long-Term Considerations and Lifestyle Adjustments

While recovering from pneumothorax, patients may need to make certain lifestyle adjustments to promote healing and reduce the risk of recurrence. What long-term considerations should patients keep in mind?

Smoking Cessation

For smokers, quitting is one of the most important steps in reducing the risk of recurrent pneumothorax. Healthcare providers can offer support and resources for smoking cessation programs.

Physical Activity and Exercise

How soon can patients return to physical activities after a pneumothorax? The timeline for resuming exercise varies depending on the individual case:

• Light activities: Gentle walking and other low-impact activities can usually be resumed within a few days, as tolerated.
• Strenuous exercise: It’s generally advisable to avoid heavy lifting and high-intensity workouts for several weeks. Consult with your healthcare provider for personalized guidance.
• Contact sports: These activities may need to be avoided for a longer period due to the risk of injury and potential recurrence.

Occupational Considerations

Depending on the nature of one’s work, some patients may need to discuss potential job modifications or temporary reassignment with their employers and healthcare providers. This is particularly relevant for occupations involving heavy lifting, exposure to pressure changes, or increased risk of chest trauma.

Prevention Strategies: Minimizing the Risk of Recurrence

While not all cases of pneumothorax can be prevented, certain strategies may help reduce the risk of recurrence. What steps can patients take to minimize their risk?

• Avoid smoking and exposure to secondhand smoke
• Practice deep breathing exercises to maintain lung health
• Use protective gear when engaging in activities with a risk of chest trauma
• Manage underlying lung conditions effectively
• Maintain a healthy lifestyle with regular exercise and a balanced diet

For patients with a history of recurrent pneumothorax or those at high risk, healthcare providers may discuss additional preventive measures, including surgical options in some cases.

Emotional and Psychological Impact: Coping with Pneumothorax

Experiencing a pneumothorax can be a stressful and anxiety-inducing event. How can patients address the emotional and psychological aspects of their recovery?

Managing Anxiety and Stress

It’s common for patients to feel anxious about the possibility of recurrence or experience stress related to lifestyle changes. Coping strategies may include:

• Practicing relaxation techniques such as deep breathing or meditation
• Engaging in gentle physical activities as approved by healthcare providers
• Seeking support from friends, family, or support groups
• Considering professional counseling if anxiety persists

Education and Empowerment

Understanding the condition and feeling prepared to manage potential complications can significantly reduce anxiety. Patients are encouraged to:

• Ask questions and seek clarification from healthcare providers
• Stay informed about the latest research and treatment options
• Develop an action plan for recognizing and responding to potential recurrence

By addressing both the physical and emotional aspects of recovery, patients can work towards a comprehensive healing process and improved quality of life following a pneumothorax.

Pneumothorax (Collapsed Lung) | Display Patient Information Leaflets

Date issued: December 2022 

Review date: December 2024

Ref: A-564/NB/ED/Pneumothorax (Collapsed Lung)

PDF:  Pneumothorax Collapsed Lung final December 2022.pdf [pdf] 139KB

What is a pneumothorax (new-mo-thor-ax)?

This means the lung has collapsed and there is air between the lung and the chest wall.  Normally this space is very small and only contains some lubricating fluid, but lung damage means air leaks into the space as well.

They can occur following injury or spontaneously.  Spontaneous pneumothoraces are more common in men, smokers and those with underlying lung disease.

Symptoms include chest pain, shortness of breath and a dry cough.

What is the treatment?

This depends on several factors:

• The cause of the pneumothorax (spontaneous or traumatic)

• Whether or not you have underlying lung disease

• What symptoms you have

• How big the pneumothorax is.

Generally speaking, if your pneumothorax was caused by trauma or is very large or making you short of breath then we will need to remove it either by sucking the air out through a needle or by placing a tube called a chest drain.  In the latter case you will need to stay in hospital but you may be able to go home if only a needle is required (aspiration of the pneumothorax).

If it is very small and isn’t causing breathing difficulties, then it is very likely to resolve without treatment.

Whether or not it is drained, it is important that you return to clinic in 7-10 days (you will be given an appointment before leaving the Emergency Department).

Can I take painkillers?

• Paracetamol is useful to ease pain. It is best to take it regularly for a few days or so, rather than every now and then. An adult dose is two 500 mg tablets, four times a day. A doctor may pre-scribe additional painkillers such as codeine if the pain is more severe.   If you are prescribed a combination of paracetamol and codeine (e.g., cocodamol or codydramol) then it is important not to take additional paracetamol as you will accidentally overdose

• Anti-inflammatory medication can be used with paracetamol or as an alternative. There are many types and brands. They relieve pain and reduce inflammation and swelling (often the cause of the pain). You can buy ibuprofen at pharmacies or supermarkets without a prescription. The dose varies depending on your age and other medical problems. Side-effects sometimes occur with anti-inflammatory painkillers. Ask your doctor or pharmacist for advice regarding them

If pain is not controlled by these simple painkillers, do not exceed the recommended dose but see your general practitioner to discuss the possibility of stronger painkillers.

South Tees Hospitals NHS Foundation Trust

Emergency Department and Minor Injury Unit

You have been given this information because you have been diagnosed with a pneumothorax.

A pneumothorax (collapsed lung) occurs when air is trapped between a lung and the chest wall. This can occur from an injury, such as broken ribs or a wound to the chest, but commonly occurs spontaneously. Spontaneous pneumothorax is thought to be due to a tiny tear of an outer part of the lung.

Treatment of a pneumothorax

A small pneumothorax may require no treatment.

A larger pneumothorax, that is causing shortness of breath, may be treated with a tube inserted into the chest known as a chest drain.

Recovering from a pneumothorax

Flying

If you currently have a pneumothorax you should not fly at all. This is because of the risk of the trapped air expanding and causing a tension pneumothorax (a life-threatening emergency), which can happen when the air pressure around you changes.

If you have had a recent pneumothorax you should have a chest x-ray performed prior to flying to ensure that it has resolved.

It is recommended that you wait at least 1 week after this chest x-ray before flying, or 2 weeks if your pneumothorax was caused by an injury.

The risk of recurrence does not fall significantly for at least 1 year, and is higher in those with coexisting lung disease. You may wish to consider alternative forms of transport during this time.

Scuba diving

This also increases the risk of developing a tension pneumothorax.

You should not scuba dive if you have ever had a spontaneous pneumothorax. If your occupation relies on diving, you may be suitable for an operation to prevent recurrence and allow you to dive again.

You may be able to dive if you have had a traumatic pneumothorax, but this depends on further investigation. Please discuss this with your GP.

Follow-up after a pneumothorax

You will be given a clinic appointment to ensure your pneumothorax has resolved. This will involve a chest x-ray.

You should seek urgent medical attention if any of the following occur:

• Increased shortness of breath
• Severe sharp, stabbing chest pain (pleuritic pain)

Treating pain

If needed, painkiller options include the following:

• Paracetamol is usually recommended for painful sprains or strains.

• Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and may also limit inflammation and swelling. You can buy some types (for example, ibuprofen) at pharmacies, without a prescription either topically as a cream, or as tablets. You should check the medication advice leaflet to ensure you are safe to take these as some patients with asthma or stomach ulcers may not be able to.

If this does not help, you may need an additional stronger painkiller – such as codeine – you should discuss this with your pharmacist or GP.

For further advice and information about your condition, please choose from the following:

• ‘NHS Patient Choices’ website: www.nhs.uk
• ‘Making Lives Better’ patient website: www.patient.info
• Telephone NHS 111
• Contact your General Practitioner

Contact details

• The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW
  Telephone: 01642 850850
• The Friarage, Northallerton, North Yorkshire, DL6 1JG
  Telephone: 01609 779911
• Redcar Primary Care Hospital, West Dyke Road, Redcar, TS10 4NW
  Telephone: 01642 511000

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.

Telephone: 01642 850850

ST1614

Page published:
10/12/2021

Page last updated:
03/03/2023

Spontaneous pneumothorax in Kyiv – private clinic Oberig.

Pneumothorax, spontaneous

Pneumothorax is an accumulation of air in the pleural cavity. With pneumothorax, the lung collapses. Lung collapse can be partial (limited) or complete.

Spontaneous pneumothorax is not associated with lung injury, infectious destruction of lung tissue, or medical procedures. There are primary spontaneous pneumothorax, which develops in patients without clinically significant signs of lung pathology, and secondary – arising against the background of existing lung diseases.

Rarely, pneumothorax occurs due to a non-pulmonary pathology, such as catamenial pneumothorax. It occurs 24 hours before or within 72 hours after the onset of menstruation, and is caused by foci of endometriosis in the chest cavity.

Bullous emphysema is the cause of primary spontaneous pneumothorax in 90% of cases. With this disease, so-called bullae are formed in the lungs – small thin-walled cavities filled with air. The bullae may rupture, and then air enters the pleural cavity. In the prevention of pneumothorax, smoking cessation is of great importance, which contributes to the development of chronic lung diseases, including bullous emphysema.

DIAGNOSTICS OF SPONTANEOUS PNEUMOTHORAX

The main diagnostic method for spontaneous pneumothorax is radiography. In most cases, radiography is sufficient to confirm or exclude the diagnosis of pneumothorax. The doctor sees on x-ray a thin line of visceral pleura that is separated from the chest, or other signs of pneumothorax.

If in doubt, computed tomography (CT) is done. This method is useful for the diagnosis of small pneumothoraxes, as well as the differential diagnosis of large bullae and pneumothorax. CT is also used to determine the cause of secondary spontaneous pneumothorax.

SYMPTOMS AND SIGNS OF SPONTANEOUS PNEUMOTHORAX

Spontaneous pneumothorax usually occurs suddenly, against the background of normal health. Although in some cases it can be provoked by physical activity, coughing, sudden movement.

The main symptoms of spontaneous pneumothorax are shortness of breath, chest pain, dry cough. The pain can be both sharp and aching, weak. It is most pronounced in the first hours after the collapse of the lung. The pain is caused by the irritating effect of air on the pleural sheets. Gives to the neck, less often to the stomach or arm. The disease is easily confused with intercostal neuralgia.

The consequences of pneumothorax can be dangerous. If a large amount of air accumulates in the pleural cavity, the mediastinal organs, including the heart, are displaced. Other complications include hemothorax, an accumulation of blood in the chest cavity.

TREATMENT OF SPONTANEOUS PNEUMOTHORAX

A patient diagnosed with pneumothorax is admitted to a specialized thoracic unit. Treatment includes three stages: expansion of the lung, determination of the causes of pneumothorax, and surgery.

Drainage of the pleural cavity is used to evacuate air and expand the lung. At the same time, diagnostic thoracoscopy is performed, which allows you to examine the chest organs and identify the cause of pneumothorax.

Spontaneous pneumothorax often recurs (in 30-50% of cases). Each episode increases the risk of the next relapse exponentially. Therefore, with spontaneous pneumothorax, surgery is indicated to prevent re-collapse of the lung.

Surgical treatment includes removal of the altered area of ​​the lung and pleurodesis – the formation of an fusion of the lung and chest wall, which protects the patient from relapses.

Today, video-assisted thoracoscopic surgery is the method of choice. The intervention is carried out through small punctures and is less traumatic. Rehabilitation after videothoracoscopic surgery for spontaneous pneumothorax is faster.

The duration of disability and return to normal life is reduced by 3-4 times. Also, thoracoscopy provides an excellent cosmetic effect, which is especially important for women.