What are the symptoms of a collapsed lung. How is pneumothorax diagnosed. What treatment options are available for pneumothorax. When can you fly after having a pneumothorax. How long does it take to recover from a collapsed lung.

What is Pneumothorax: Defining a Collapsed Lung

Pneumothorax, commonly known as a collapsed lung, occurs when air becomes trapped between the lung and the chest wall. This condition can arise from various causes, including injury or spontaneously without apparent reason. Understanding the nature of pneumothorax is crucial for proper management and recovery.

Normally, the space between the lung and chest wall is minimal, containing only lubricating fluid. However, when lung damage occurs, air can leak into this space, leading to lung collapse. This situation can cause significant discomfort and breathing difficulties for the affected individual.

Who is at Risk for Pneumothorax?

Certain factors increase the likelihood of experiencing a pneumothorax:

• Gender: Men are more prone to spontaneous pneumothorax than women
• Smoking: Tobacco use significantly raises the risk
• Underlying lung diseases: Conditions like COPD or cystic fibrosis can predispose individuals to pneumothorax
• Tall, thin body type: This physical characteristic is associated with a higher risk
• Previous pneumothorax: Having experienced one increases the chances of recurrence

Understanding these risk factors can help individuals take preventive measures and seek timely medical attention if symptoms arise.

Recognizing Pneumothorax Symptoms: Key Indicators of a Collapsed Lung

Identifying the symptoms of pneumothorax is crucial for prompt diagnosis and treatment. The primary indicators include:

• Sudden, sharp chest pain that may worsen with deep breathing or coughing
• Shortness of breath or difficulty breathing
• Dry, persistent cough
• Rapid heart rate
• Bluish skin color due to lack of oxygen (in severe cases)

These symptoms can vary in intensity depending on the size of the pneumothorax and the individual’s overall health. It’s important to note that some small pneumothoraces may not cause noticeable symptoms initially.

When to Seek Medical Attention

If you experience sudden chest pain accompanied by difficulty breathing, it’s crucial to seek immediate medical care. These symptoms could indicate a pneumothorax or other serious cardiac or pulmonary conditions requiring prompt evaluation.

Diagnosing Pneumothorax: Medical Procedures and Imaging Techniques

Accurate diagnosis of pneumothorax is essential for appropriate treatment. Healthcare providers use various methods to confirm the presence and extent of a collapsed lung:

1. Physical examination: Doctors listen to breath sounds and assess chest movement
2. Chest X-ray: The primary imaging tool for visualizing a pneumothorax
3. CT scan: Provides detailed images, especially useful for small pneumothoraces
4. Ultrasound: Can be used for rapid bedside assessment in emergency situations

These diagnostic tools help determine the size and location of the pneumothorax, guiding treatment decisions and monitoring recovery progress.

Understanding Chest X-ray Findings

On a chest X-ray, a pneumothorax appears as a dark area along the chest wall, representing the space filled with air. The size of this dark area helps clinicians categorize the pneumothorax as small, moderate, or large, influencing the treatment approach.

Treatment Options for Pneumothorax: From Conservative Management to Invasive Procedures

The treatment of pneumothorax depends on several factors, including the cause, size, and symptoms associated with the collapsed lung. Healthcare providers consider these aspects when determining the most appropriate course of action:

Conservative Management

For small, asymptomatic pneumothoraces, especially those occurring spontaneously, a conservative approach may be sufficient. This involves:

• Close monitoring with repeated chest X-rays
• Oxygen therapy to help reabsorb the trapped air
• Pain management with over-the-counter or prescribed medications

Needle Aspiration

In cases where the pneumothorax is larger or causing symptoms, needle aspiration may be attempted. This procedure involves:

• Inserting a needle into the chest cavity
• Removing the excess air to allow the lung to re-expand
• Monitoring for improvement and potential recurrence

Chest Tube Insertion

For more severe or persistent pneumothoraces, a chest tube may be necessary. This procedure involves:

• Placing a flexible tube into the chest cavity
• Connecting the tube to a one-way valve system or suction
• Allowing continuous drainage of air until the lung fully re-expands
• Hospital admission for monitoring and management

Surgical Intervention

In some cases, particularly for recurrent pneumothoraces or those that don’t resolve with other treatments, surgery may be recommended. Surgical options include:

• Video-assisted thoracoscopic surgery (VATS)
• Pleurodesis to prevent future air leaks
• Bullectomy to remove weakened areas of the lung

The choice of treatment depends on the individual case and is made in consultation with healthcare providers to ensure the best possible outcome.

Recovery and Follow-up Care: Ensuring Proper Healing After Pneumothorax

Recovering from a pneumothorax requires careful attention to follow-up care and lifestyle modifications. Patients should adhere to the following guidelines:

Follow-up Appointments

Typically, patients are scheduled for a follow-up appointment 7-10 days after initial treatment. This visit includes:

• A chest X-ray to confirm resolution of the pneumothorax
• Assessment of overall recovery and symptom improvement
• Discussion of any concerns or questions

Pain Management

Managing discomfort during recovery is important. Guidelines for pain relief include:

• Regular use of paracetamol (acetaminophen) as directed
• Use of prescribed painkillers, such as codeine, if needed for severe pain
• Consideration of anti-inflammatory medications, with doctor approval
• Avoiding exceeding recommended dosages of any medication

Activity Restrictions

During the recovery period, certain activities should be limited:

• Avoiding strenuous exercise until cleared by a healthcare provider
• Refraining from heavy lifting or activities that increase chest pressure
• Gradually returning to normal activities as directed by medical professionals

Adhering to these guidelines promotes proper healing and reduces the risk of complications or recurrence.

Air Travel and Diving Restrictions: Navigating Post-Pneumothorax Precautions

After experiencing a pneumothorax, certain activities that involve pressure changes require special consideration to ensure safety and prevent recurrence.

Air Travel Restrictions

Flying after a pneumothorax carries potential risks due to changes in air pressure. Guidelines for air travel include:

• Avoiding all air travel while a pneumothorax is present
• Waiting at least 1 week after a clear chest X-ray before flying
• Extending the waiting period to 2 weeks for traumatic pneumothorax
• Considering alternative transportation methods during the first year post-pneumothorax

Scuba Diving Considerations

Scuba diving presents significant risks for individuals with a history of pneumothorax:

• Permanent avoidance of scuba diving for those with spontaneous pneumothorax history
• Potential for diving after traumatic pneumothorax, subject to medical evaluation
• Consideration of surgical intervention for occupational divers to prevent recurrence

These restrictions are crucial for preventing potentially life-threatening complications associated with pressure changes in these activities.

Preventing Recurrence: Strategies to Minimize Future Pneumothorax Risk

While not all cases of pneumothorax can be prevented, certain measures can help reduce the risk of recurrence or initial occurrence:

Smoking Cessation

Quitting smoking is one of the most effective ways to reduce pneumothorax risk. Benefits include:

• Improved lung health and function
• Reduced inflammation in the airways
• Decreased likelihood of spontaneous pneumothorax

Managing Underlying Lung Conditions

For individuals with pre-existing lung diseases, proper management is crucial:

• Adhering to prescribed treatments for conditions like COPD or asthma
• Regular check-ups with pulmonary specialists
• Prompt treatment of respiratory infections

Lifestyle Modifications

Certain lifestyle changes can contribute to overall lung health:

• Maintaining a healthy weight
• Engaging in regular, moderate exercise as approved by healthcare providers
• Avoiding exposure to air pollution and irritants

Occupational Considerations

For those in high-risk occupations, additional precautions may be necessary:

• Using appropriate protective equipment in dusty or hazardous environments
• Regular health screenings for early detection of lung issues
• Discussing job-related risks with healthcare providers

By implementing these preventive strategies, individuals can significantly reduce their risk of experiencing a pneumothorax or its recurrence, promoting long-term lung health and overall well-being.

When to Seek Emergency Care: Recognizing Serious Pneumothorax Complications

While many cases of pneumothorax resolve with treatment, it’s crucial to be aware of signs that indicate a need for immediate medical attention. Recognizing these symptoms can prevent potentially life-threatening complications:

Red Flag Symptoms

Seek emergency care if you experience any of the following after being diagnosed with or treated for pneumothorax:

• Sudden, severe increase in chest pain
• Rapid onset or worsening of shortness of breath
• Bluish discoloration of the lips or skin (cyanosis)
• Dizziness, lightheadedness, or fainting
• Rapid heart rate or palpitations
• Confusion or altered mental state

Tension Pneumothorax

A particularly serious complication is tension pneumothorax, which requires immediate intervention. Signs include:

• Severe respiratory distress
• Tracheal deviation (shift of the windpipe to one side)
• Distended neck veins
• Rapid deterioration of vital signs

Tension pneumothorax is a medical emergency that can be life-threatening if not treated promptly. If you suspect this condition, call emergency services immediately.

Post-Treatment Complications

For those who have undergone treatment for pneumothorax, be alert for signs of complications such as:

• Fever or chills, which could indicate infection
• Persistent air leak from a chest tube
• Increasing pain or swelling around the treatment site
• Coughing up blood

Prompt reporting of these symptoms to your healthcare provider can ensure timely intervention and prevent more serious complications.

Long-Term Outlook: Understanding the Prognosis and Future Health Considerations

The long-term outlook for individuals who have experienced pneumothorax varies depending on several factors. Understanding the prognosis and potential future health considerations is crucial for ongoing management and prevention.

Recurrence Rates

The risk of pneumothorax recurrence is an important consideration:

• First-time spontaneous pneumothorax: Approximately 30% chance of recurrence
• Second occurrence: Up to 50% chance of another episode
• Risk remains elevated for at least one year after the initial event

Factors Influencing Prognosis

Several factors can affect the long-term outlook:

• Underlying lung conditions: Presence of diseases like COPD can increase recurrence risk
• Smoking status: Continued smoking significantly raises the likelihood of future episodes
• Treatment method: Surgical interventions may reduce recurrence rates compared to conservative management
• Age and overall health: Younger, healthier individuals often have better outcomes

Long-Term Health Monitoring

Ongoing health surveillance is important for those with a history of pneumothorax:

• Regular follow-up appointments with pulmonary specialists
• Periodic chest X-rays or CT scans as recommended by healthcare providers
• Monitoring for symptoms of respiratory issues
• Adherence to prescribed medications and treatments for underlying lung conditions

Quality of Life Considerations

For many individuals, quality of life returns to normal after recovery from pneumothorax. However, some may experience:

• Lingering anxiety about recurrence
• Need for lifestyle modifications, particularly regarding high-risk activities
• Ongoing management of underlying lung conditions

Addressing these aspects through proper medical care and, if necessary, psychological support can help maintain a good quality of life post-pneumothorax.

Advances in Treatment and Prevention

Ongoing research in pneumothorax management offers hope for improved outcomes:

• Development of less invasive treatment techniques
• Improved understanding of genetic factors contributing to pneumothorax risk
• Advancements in lung imaging technology for earlier detection and monitoring

Staying informed about these developments and maintaining open communication with healthcare providers can help individuals optimize their long-term health management strategies.

By understanding the long-term outlook and adhering to recommended follow-up care, individuals who have experienced pneumothorax can effectively manage their health and minimize the impact on their daily lives. Regular medical supervision and a proactive approach to lung health are key components of a positive long-term prognosis.

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.

The Oberig Universal Clinic has a powerful diagnostic base and the most modern video-assisted thoracoscopic equipment from the world’s leading manufacturers.

Make an appointment with highly qualified specialists of the Thoraco-Pulmonology Center by phone:

(044) 521 30 03

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