What to do for a collapsed lung: Pneumothorax – Symptoms and causes
Pneumothorax – Care at Mayo Clinic
Pneumothorax care at Mayo Clinic
Your Mayo Clinic care team
Mayo Clinic pulmonologists are part of an integrated team of highly specialized medical and surgical experts who work together to care for people of all ages. They use the latest technology to provide exactly the care you need for your pneumothorax.
Your pulmonologist can collaborate with experts in various specialties to deliver effective, personalized care. This tradition of collaboration helps ensure your doctor develops an individualized treatment plan for your pneumothorax that considers your needs and all aspects of your condition.
Advanced diagnosis and treatment
Pulmonary and critical care specialists at Mayo Clinic are experts at solving the most serious and complex medical challenges faced by people with conditions that affect the lungs and breathing.
Experts use the latest equipment and, when possible, minimally invasive techniques to treat a pneumothorax. And their commitment to innovation and research means that you have access to advanced treatment options.
Expertise and rankings
- Expertise. Highly skilled pulmonologists, radiologists, thoracic surgeons and other experts at Mayo Clinic work together as a team to provide the best quality care for people who have a pneumothorax.
- Experience. Mayo Clinic is one of the leading medical facilities in North America for the diagnosis and treatment of lung (pulmonary) conditions and diseases. Each year, specialists at Mayo Clinic treat more than 1,000 people who have a pneumothorax.
Locations, travel and lodging
Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.
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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.
In most cases, Mayo Clinic doesn’t require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
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Collapsed Lung (Pneumothorax): Symptoms, Causes & Treatment
What is a collapsed lung?
A collapsed lung occurs when air enters the pleural space, the area between the chest wall and the lung. Air in the pleural space can build up and press against the lung, causing it to collapse partially or fully. Also called a deflated lung or pneumothorax, a collapsed lung needs immediate medical care.
What are the different types of collapsed lung?
There are five main types of collapsed lung:
- Primary spontaneous pneumothorax: Collapsed lung sometimes happens in people who don’t have other lung problems. It can occur due to abnormal air sacs in the lungs that break apart and release air.
- Secondary spontaneous pneumothorax: Several lung diseases may cause a collapsed lung. These include chronic obstructive pulmonary disease (COPD), cystic fibrosis and emphysema.
- Injury-related pneumothorax: Injury to the chest can cause collapsed lung. Some people experience a collapsed lung due to a fractured rib, a hard hit to the chest or a knife or gunshot wound.
- Latrogenic pneumothorax: After certain medical procedures such as lung biopsy or a central venous line insertion, some people can have complications that include a pneumothorax.
- Catamenial pneumothorax: This rare condition affects women who have endometriosis. Endometrial tissue lines the uterus. With endometriosis, it grows outside the uterus and attaches to an area inside the chest. The endometrial tissue forms cysts that bleed into the pleural space, causing the lung to collapse.
Symptoms and Causes
What causes a collapsed lung?
Pneumothorax has three main causes: medical conditions, injuries and lifestyle factors.
Medical conditions that may cause a collapsed lung include:
Injuries that may cause collapsed lung are:
- Blunt force trauma.
- Certain types of ventilation or changes to ventilation.
- Gunshot wound.
- Lung puncture during a medical procedure, like a biopsy or nerve block.
- Stab wound.
Lifestyle factors associated with collapsed lung are:
- Drug use, especially inhaled drugs.
- Flying that involves drastic changes in air pressure.
- Scuba or deep-sea diving.
People with certain other risk factors may be more likely to have a collapsed lung. These are:
- Family history of pneumothorax.
- Tall, thin body type.
What are the symptoms of collapsed lung?
A collapsed lung can have many signs and symptoms. If you have symptoms of a collapsed lung, go to the emergency room. You may need immediate care.
Signs of a collapsed lung include:
Diagnosis and Tests
How is a collapsed lung diagnosed?
Your healthcare provider will ask about your history of lung disease and perform a physical exam. They may also measure the level of certain gases in your bloodstream. To measure gases like oxygen and carbon dioxide, a technician collects a blood sample and analyzes it in a lab.
The most common way to diagnose a collapsed lung is with medical imaging. Usually, you’ll have a chest X-ray. But you may have a CT scan or ultrasound.
Management and Treatment
How is collapsed lung treated?
Your treatment depends on the cause, size and severity of your pneumothorax. Collapsed lung treatment may include:
Observation: If your pneumothorax is minor, your provider may watch you for signs of heart or breathing problems. You will see your provider for a follow-up visit.
Supplemental oxygen: Your provider may give you extra oxygen if your pneumothorax is small but you have symptoms. Your provider watches to make sure your condition is stable.
Needle aspiration: During aspiration, a provider uses a syringe to remove some of the air in the pleural space. A provider may follow needle aspiration with percutaneous chest tube drainage.
Chest tube drainage: If you have a larger pneumothorax, your provider may put a hollow tube in your chest to reduce the air in the pleural space. As the air pressure decreases, the lung re-expands and heals. You may have this tube in place for a couple of days or longer.
Chemical pleurodesis: To prevent the lung from collapsing again, a provider may perform pleurodesis. Your provider makes an incision and inserts a tube. Then your provider uses chemicals (such as doxycycline or talc) to attach the lung to the chest cavity, eliminating extra space in the chest cavity.
Surgery: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure that uses a small camera to help the surgeon remove lung tissue. Your surgeon may also perform a chemical pleurodesis or a mechanical pleurodesis using a piece of gauze to attach the lung to the chest cavity. You may be a candidate for surgery if you don’t respond to other treatment or have:
- Persistent air leakage from chest tube.
- Lung that does not expand despite chest tube insertion.
- Recurrent collapse lung.
- Pneumothorax in both lungs.
- Traumatic lung injuries.
What are the complications of a collapsed lung?
Although most collapsed lungs heal without problems, serious complications do occur. These can include:
- Re-expansion pulmonary edema, when extra fluid is in the lungs.
- Damage or infection caused by the treatment.
- Inability to breathe.
- Heart failure.
Can I prevent a collapsed lung?
If you have certain medical conditions or a family history of pneumothorax, you might not be able to prevent a collapsed lung.
Anyone can take steps to reduce your chances of collapsed lung:
- Stop smoking.
- Avoid or limit activities with drastic changes in air pressure (scuba diving and flying). Follow your provider’s recommendations if you do these activities.
- See your provider regularly to monitor any lung conditions.
Outlook / Prognosis
What is the outlook for collapsed lung?
Most people who have a collapsed lung generally heal without major treatment. If you’ve had a collapsed lung, you have a higher chance of having it again.
What can I expect after treatment for a collapsed lung?
After treatment, you may be in the hospital for a couple of days or longer. This allows your provider to check your progress and give you oxygen, if necessary.
You will make an appointment for follow-up visits. You should contact your provider if symptoms of collapsed lung return.
Your provider will also recommend avoiding:
- Air travel for two weeks.
- Scuba or deep-sea diving, possibly permanently.
What should I ask my healthcare provider?
If you have a collapsed lung, ask your provider:
- What caused my collapsed lung?
- Is there anything I can do to prevent another collapsed lung?
- Do I need treatment for my collapsed lung?
- If I need to have a chest tube, how long will I have it?
- Will I need extra oxygen?
- Will I need to stay in the hospital?
- What kind of care will I need after treatment?
- What kind of care will I need after I leave the hospital or clinic?
- What should I avoid doing after my treatment?
A note from Cleveland Clinic
A collapsed lung is rare, but it can be serious. If you have signs or symptoms of a collapsed lung, such as chest pain or trouble breathing, get medical care right away. Your lung may be able to heal on its own, or you may need treatment to save your life. Your provider can determine the best form of treatment for you.
Acute Respiratory Distress Syndrome (ARDS): Symptoms, Treatment
What is acute respiratory distress syndrome (ARDS)?
Acute respiratory distress syndrome, or ARDS, is an inflammatory lung injury that happens when fluids build up in small air sacs (called alveoli) in the lungs. ARDS prevents the lungs from filling up with air and causes dangerously low oxygen levels in the blood (hypoxemia).
This condition prevents other organs such as brain, heart, kidneys and stomach from getting the oxygen they need to function. ARDS is dangerous and can lead to a number of serious and life-threatening problems.
ARDS typically happens in hospital settings while the patient is being treated for infection or trauma. If you’re not hospitalized and experience symptoms of ARDS, get medical attention immediately.
Symptoms and Causes
What causes acute respiratory distress syndrome (ARDS)?
ARDS is caused when fluids leak from small lung vessels into lung air sacs (alveoli). When the protective membrane between blood vessels and air sacs is compromised, levels of oxygen in the blood decrease.
Causes of ARDS include:
- Sepsis: The most common cause of ARDS, a serious infection in the lungs (pneumonia) or other organs with widespread inflammation.
- Aspiration pneumonia: Aspiration of stomach contents into the lungs may cause severe lung damage and ARDS.
- The coronavirus (COVID-19): The infection COVID-19 may develop into severe ARDS.
- Pancreatitis (severe inflammation in the pancreas), and massive blood transfusion.
- Major trauma and burns: Accidents and falls may directly damage the lungs or other organs in the body that trigger severe inflammation injury in the lungs.
- Inhalational injury: Breathing and exposure to high concentrations of chemical fumes or smoke.
- Drug overdose: An overdose on drugs like cocaine and opioids.
What are the symptoms of acute respiratory distress syndrome (ARDS)?
Symptoms of ARDS depend on the cause and severity of the case, as well as pre-existing lung or heart conditions. Symptoms include:
- Severe shortness of breath or breathlessness.
- Rapid and labored breathing.
- Extreme tiredness and muscle fatigue.
- Rapid heart rate.
- Bluish color of fingernails and lips due to low oxygen level in the blood.
- Cough and chest pain.
If ARDS is caused by severe infection (sepsis), symptoms of sepsis may also be present (fever, low blood pressure).
How quickly can acute respiratory distress syndrome (ARDS) develop?
ARDS tends to develop within a few hours to a few days of the event that caused it. ARDS can worsen rapidly.
Diagnosis and Tests
What tests are done to diagnose acute respiratory distress syndrome (ARDS)?
When symptoms of ARDS occur, a combinations of tests may be done:
- Chest X-ray to measure fluids in the lungs.
- A blood test to determine oxygen level in the blood to help determine the severity of ARDS.
- Echocardiogram (ultrasound of the heart) to evaluate heart function.
Sometimes, symptoms and signs of ARDS may require additional tests to diagnose other causes that are similar to ARDS.
- A computerized tomography (CT scan) may be done to gain detailed information about the lungs.
- Sampling of secretions from the airways may be taken to find the cause of infection.
Management and Treatment
How is acute respiratory distress syndrome (ARDS) treated?
ARDS is usually treated in the intensive care unit (ICU) along with treatment of the underlying cause.
Mechanical ventilation (a ventilator) is often used in caring for patients with ARDS. For milder cases of ARDS, oxygen may be given through a fitted face mask or a cannula fitted over the nose.
Steps to minimize complications (see below) from ARDS are commonly used. These include:
- Sedation to manage pain.
- Breathing tests to determine when it’s safe to remove the tube and ventilator.
- Blood thinners to prevent clots.
- Minimizing fluid buildup in the lungs.
- Minimizing stress ulcers in the stomach.
- Active mobility and physical therapy to prevent muscle weakness.
No direct drug therapy has been shown to improve survival in ARDS, but researchers continue to work on finding treatment.
What complications can develop from acute respiratory distress syndrome (ARDS)?
Complications and problems from ARDS may develop while a patient is in the hospital or after discharge.
Outlook / Prognosis
What is the outlook for acute respiratory distress syndrome (ARDS)?
ARDS can be life-threatening and deadly. But improved care and ventilator treatments — including prone ventilation with patients lying face down to improve oxygen flow — are now helping more people survive and reduce risk of complications from ARDS.
Recovery from ARDS may take a long time. Most patients can be removed from the ventilator and breathe freely. Some recover completely, but others may develop chronic lung problems that require care by lung doctors (pulmonologists). Some patients may develop post-intensive care syndrome (PICS) and can experience post-traumatic stress disorder, physical weakness, and anxiety and depression.
A note from Cleveland Clinic
Time in the ICU can be traumatic and hard. People recovering from ARDS may not be able to go back to everyday life and work quickly, and need support. Getting professional help and advice is important along the road to recovery from ARDS. Ask your healthcare team about any post intensive care recovery programs in your area and online support groups (such as aftertheicu.org) that are available.
What is a mechanical ventilator?
A mechanical ventilator is a machine that helps a patient breathe (ventilate) when they are having surgery or cannot breathe on their own due to a critical illness. The patient is connected to the ventilator with a hollow tube (artificial airway) that goes in their mouth and down into their main airway or trachea. They remain on the ventilator until they improve enough to breathe on their own.
Why do we use mechanical ventilators?
A mechanical ventilator is used to decrease the work of breathing until patients improve enough to no longer need it. The machine makes sure that the body receives adequate oxygen and that carbon dioxide is removed. This is necessary when certain illnesses prevent normal breathing.
What are the benefits of mechanical ventilation?
The main benefits of mechanical ventilation are the following:
- The patient does not have to work as hard to breathe – their respiratory muscles rest.
- The patient’s as allowed time to recover in hopes that breathing becomes normal again.
- Helps the patient get adequate oxygen and clears carbon dioxide.
- Preserves a stable airway and preventing injury from aspiration.
It is important to note that mechanical ventilation does not heal the patient. Rather, it allows the patient a chance to be stable while the medications and treatments help them to recover.
What are the risks of mechanical ventilation?
The main risk of mechanical ventilation is an infection, as the artificial airway (breathing tube) may allow germs to enter the lung. This risk of infection increases the longer mechanical ventilation is needed and is highest around two weeks. Another risk is lung damage caused by either over inflation or repetitive opening and collapsing of the small air sacs Ialveoli) of the lungs. Sometimes, patients are unable to be weaned off of a ventilator and may require prolonged support. When this occurs, the tube is removed from the mouth and changed to a smaller airway in the neck. This is called a tracheostomy. Using a ventilator may prolong the dying process if the patient is considered unlikely to recover.
What procedures can help a patient with an artificial airway connected to a mechanical ventilator?
- Suctioning: This is a procedure in which a catheter (a thin, hollow tube) is inserted into the breathing tube to help remove secretions (mucus). This procedure may make the patient cough or gag, and it may be uncomfortable to watch. Also, secretions may develop a blood tinge from the act of suctioning. It is important to understand that this is a vital procedure for keeping the airways clear of secretions.
- Aerosolized (spray) medications: A patient may need medications that are delivered through the breathing tube. These medications may be targeted to the airway or the lung and may be more effective when delivered this way.
- Bronchoscopy: In this procedure, the doctor inserts a small light with a camera into the airway of the patient through the breathing tube. This is a very effective tool for checking the airways in the lungs. Sometimes the physician will take samples of mucus or tissue in order to guide the patient’s therapy.
How long does the patient stay connected to the mechanical ventilator?
The main purpose of a mechanical ventilator is to allow the patient time to heal. Usually, as soon as a patient can breathe effectively on their own, they are taken off the mechanical ventilator.
The caregivers will perform a series of tests to check the patient’s ability to breathe on their own. When the cause for the breathing problem is improved and it is felt that the patient can breathe effectively on their own, they are taken off of the mechanical ventilator.
Who are the caregivers who take care of the patient on a mechanical ventilator?
- Physician: The physician is usually an anesthesiologist, pulmonologist, or intensivist (critical care physician). These doctors have special training in the art and science of mechanical ventilation and take care of these patients every day.
- Nurse practitioner: The nurse practitioner helps the doctor evaluate the patient and write orders for therapy. Nurse practitioners in critical care areas are specially trained in the care of patients who are connected to mechanical ventilators.
- Registered nurse: The registered nurses taking care of patients on mechanical ventilation have received special training in the care of these patients.
- Respiratory therapist: The respiratory therapist is trained in the assessment, treatment, and care of patients with respiratory (breathing) diseases and patients with artificial airways who are connected to mechanical ventilators.
- Patient care associate: The patient care associate is trained to care for patients in a critical care setting.
Lymphangioleiomyomatosis: Symptoms, Causes, Treatments
What is lymphangioleiomyomatosis (LAM)?
Lymphangioleiomyomatosis (LAM) is a lung disease caused by the abnormal growth of smooth muscle cells, especially in the lungs and lymphatic system. This abnormal growth leads to the formation of holes or cysts in the lung.
People who have LAM have trouble breathing because it is more difficult to move air in and out of the bronchial tubes. Also, the replacement of normal lung tissue with cysts or holes weakens the ability of the lungs to move oxygen into the bloodstream.
Cysts or holes also put patients at risk for developing pneumothorax, which is a buildup of air or gas in the lining (pleura) of the the lungs, causing a collapsed lung.
Patients with LAM may also develop growths in the kidneys called angiomyolipomas. These are harmless unless they become large, in which case they can cause bleeding.
Who gets lymphangioleiomyomatosis (LAM)?
Lymphangioleiomyomatosis (LAM) almost exclusively affects women. Women who have the disease are usually diagnosed between the ages of 20 and 40. About 30% of women who have tuberous sclerosis also have LAM.
Symptoms and Causes
What causes lymphangioleiomyomatosis (LAM)?
Lymphangioleiomyomatosis (LAM) results from changes in two genes called TSC1 and TSC2. There is a hereditary form of the disease that occurs in patients who have a disease called tuberous sclerosis.
There is a second form of LAM that is not associated with tuberous sclerosis, called sporadic LAM. People who have sporadic LAM also have genetic mutations, but the gene mutations are not hereditary and cannot be passed on to children. The reason these gene mutations occur is unclear.
What are the symptoms of lymphangioleiomyomatosis (LAM)?
The abnormal growth of smooth muscle cells and cysts in the lungs of patients who have lymphangioleiomyomatosis (LAM) can cause the following symptoms:
Diagnosis and Tests
How is lymphangioleiomyomatosis (LAM) diagnosed?
Because symptoms of lymphangioleiomyomatosis (LAM) are similar to those of asthma or bronchitis, many women who have LAM may not realize it right away, or are given the incorrect diagnosis by doctors who are unfamiliar with the disease. Similarly, the cysts in the lung can be misdiagnosed as emphysema.
LAM is usually treated by a pulmonologist, a doctor who specializes in treating lung diseases. It is important that the doctor be familiar with LAM, and diseases that can mimic LAM, to correctly diagnose and treat the disease. The doctor will examine you and ask about your symptoms. The doctor may also order certain tests, including the following:
- High-resolution computed tomography (CT) scan: This scan creates a sharp picture of the lungs to see if the cysts, the main sign of the disease, are present in the lung. This scan can also show if there is any fluid (pleural effusion) around the lungs.
- Lung function tests: In this test, you breathe into a machine called a spirometer to determine how much air you can inhale and exhale and whether your lungs are functioning normally.
- Pulse oximetry: This test uses a small instrument, attached to your finger, to measure how much oxygen is in your blood.
- VEGF-D blood test: This blood test measures the level of a hormone in your body called VEGF-D. If you have cysts in your lung and an extremely high level of VEGF-D, a diagnosis of LAM can be made without need for a biopsy. However, a normal level does not rule out the possibility of LAM.
- CT scan or MRI of the abdomen : These scans create an image of the abdomen and can help make the diagnosis of LAM.
- Lung biopsy: In some cases, it is necessary to obtain a small piece of tissue lung and examine under the microscope to diagnose LAM or to look for other diseases that can look like LAM. This can be done in one of two ways:
- Transbronchial biopsy: With this method, the doctor inserts a lighted tube called a bronchoscope into the lungs through the trachea (windpipe) to take samples of the lung. This can be done as an outpatient and does not involve surgery.
- Video-assisted thoracoscopy: This method is a surgical procedure performed under general anesthesia. The surgeon makes small incisions (cuts) in the chest and inserts a lighted scope to look at the lungs. The doctor can also take biopsies of the lung to examine more closely.
Management and Treatment
How is lymphangioleiomyomatosis (LAM) treated?
There is no cure for lymphangioleiomyomatosis (LAM), but there is now effective treatment to stabilize the disease and prevent it from progressing (getting worse). The drug sirolimus (also known as rapamycin or by the branded name Rapamune® ) is used in patients who show signs that they have lost lung function as a result of LAM. Sirolimus can also be used to shrink large angiomyolipomas of the kidney. In some cases, another medication of the same class, everolimus (Afinitor®, Zortress®), can be used to treat LAM.
Other treatments that may be used in some situations include:
- Oxygen therapy.
- Inhaled medications that help improve the flow of air in the lungs.
- Various procedures to remove fluid from the chest, or to shrink angiomyolipomas.
- Lung transplant (in severe cases of LAM).
Outlook / Prognosis
What is the prognosis (outlook) for patients who have lymphangioleiomyomatosis (LAM)?
Untreated, lymphangioleiomyomatosis (LAM) can be a progressive disease, which means it can get worse over time. With the use of sirolimus, the hope is that the disease can be stabilized for most patients (though not all patients respond to the drug). In the past, the prognosis for patients with LAM was poor, but this is no longer true. Currently, more than 90% of patients are alive 10 years after their diagnosis.
If you’ve been diagnosed with LAM see your doctors on a regular basis and try to live a healthy lifestyle. Having LAM may cause anxiety and depression as well, so seek emotional support if needed.
Collapsed Lung | Surgery | Lafayette, CO
A collapsed lung is rare, but does occur for thousands of people each year. Often the condition resolves on its own after a few days to a few weeks. But some cases need medical care offered in a hospital. Trust us to provide the specialized pulmonary care you need.
Learn what causes collapsed lungs, the symptoms and your options for treatment.
What is a collapsed lung?
A collapsed lung, or a pneumothorax, occurs when air from your lung leaks into your chest cavity. The build up of air in the space between the lung and the chest wall puts pressure on your lung, causing it to collapse.
Pneumothorax can occur for many reasons.
- Blunt trauma to the chest causing a rib fracture
- Blunt injury to the chest, like a fall or car accident, pushing the air out of the lungs
- Damage of lung tissue from diseases such as COPD, asthma, cystic fibrosis or pneumonia
- Penetrating injury to the chest, like a stab wound or gunshot
- Smoking cigarettes and marijuana
What a collapsed lung looks like
The lungs sit in the chest, inside the ribcage. They are covered with a thin membrane called the “pleura.” The windpipe (or trachea) branches into smaller airways. In this drawing, 1 lung is normal, and 1 has collapsed because air has leaked out of it. The air that has leaked out of the lung (shown in blue) has filled the space outside of the lung.
Reproduced with permission from: Patient Information: Pneumothorax (collapsed lung) (The Basics). In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA 2012. Copyright © 2012 UpToDate, Inc. For more information visit www.uptodate.com.
Tension pneumothorax is a severe condition. It is a life-threatening emergency and requires immediate medical attention. If your diagnosis is tension pneumothorax, the air outside your lung has no place to escape. Instead, it continues to increase and causes pressure on vital organs, such as your heart. This eventually will cause your vital organs to shut down and stop working.
Tension pneumothorax requires immediate medical attention as it can be fatal. The chest cavity needs decompression, or releasing of pressure, immediately. We then place a chest tube between your ribs to your lung to help you recover.
Symptoms of a collapsed lung
You should seek medical attention immediately if you have any of these symptoms.
- Shortness of breath, or difficulty taking a full breath; may be mild to severe
- Sudden, sharp, sometimes stabbing chest pain or chest tightness
People with a small pneumothorax might not have any symptoms. They might find out that they have it when they have a chest X-ray for another reason.
Testing for a pneumothorax
Your doctor or nurse will ask about your symptoms, do an exam, and do a chest x-ray.
He or she might also do a CT scan. A CT scan is an imaging test. It creates pictures of the inside of your body to better check your lungs and surrounding organs.
Treatment of pneumothorax
Your treatment will depend on your symptoms and how small or large the pocket of air outside your lungs are.
- Small Pneumothorax – If your pneumothorax is small, your doctor might treat you by giving you oxygen and observing you. That’s because a small pneumothorax sometimes will get better on its own. To follow your condition, your doctor might do a few chest X-rays over time. Often your doctor will admit you to the hospital for observation. This allows us to treat you quickly if your condition worsens.
- Larger pneumothorax – If your pneumothorax is large or causing symptoms, your doctor will need to intervene. He of she will remove the air that has collected outside of your lung. Although we can do this in a few different ways, a chest tube is the most common. Placing your chest tube involves your doctor making a small hole between your ribs where we insert the tube. The tube provides an escape valve for the air trapped in your chest cavity. The tube will stay in your chest for a few days, or more, until air is no longer leaking out of the lung. You will need to stay in the hospital while this tube is in your chest. Before discharge from the hospital, we will want to have a chest x-ray and a physical examination.
Surgery for pneumothorax
In cases where a chest tube doesn’t work, your doctor might need to do lung surgery to close off the air leak. We call this surgery “thoracoscopy” or VATS (Video-assisted Thoracic Surgery). During thoracoscopy, the doctor will give you medicine to make you sleep. Then he or she will make 2 or 3 small cuts between the ribs in your chest. He or she will put long, thin tools in these openings and into the space where the air collected. One of the tools has a camera on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to do the surgery.
If you need surgery to treat your condition, your doctor might do another procedure at the same time. These two procedures can help prevent a future pneumothorax.
- Pleurodesis – This is a procedure that creates inflammation in the inside lining of your chest wall. The lung becomes large enough to stick and adhere to the chest wall. This prevents your lung from collapsing again. Your doctor might recommend this procedure you have had more than 1 pneumothorax. Having more than ones puts you at higher risk of having it happen again in the future.
- Bleb Resection – A bleb is an abnormal part of the lung that can rupture and cause a pneumothorax. Tiny air sacs make up your lung tissue. In certain lung and connective tissue diseases, these tiny air sacs combine and form a larger bubble or a bleb. If we find blebs during surgery, we will remove them to prevent repeat rupturing.
Recovery after a Pneumothorax:
After surgery you will have a chest tube placed. It will stay in for several days to a week, depending on your healing process. To ensure we placed your tube in the most optimal location for your lung, we will give you x-rays and an examination. You will need to stay in the hospital while the chest tube is in place. After removal of you chest tube and before you go home, your doctor will confirm that your lung has not re-collapsed. We give you instructions on breathing exercises, called incentive spirometry. These help expand your lungs and dialate your air sacs. This will help prevent pneumonia.
If you smoke, you should stop smoking. Smoking can increase your chance of getting pneumothorax. Smoking cessation will help your body recovery more completely. It will also help with your wound healing treatment.
You should also ask your doctor when you can fly in an airplane again. You will generally need to wait at least 2 weeks, and up to 12 weeks, before using this transportation. Flying in an airplane or traveling to areas where the elevation is higher than 8000ft are dangerous. The pressure change can cause your lung to re-collapse if it is not yet healed.
Collapsed Lung – Symptoms, Causes, Treatments
A collapsed lung is the deflation of some or all of a lung, resulting in difficulty breathing, chest pain, and low oxygen in the blood (hypoxia). Collapsed lung can refer to a pneumothorax, an accumulation of air in the chest that prevents the lungs from expanding fully, or to atelectasis, deflation of the tiny air sacs (alveoli) within the lungs.
More specifically, a pneumothorax begins as a hole in the lung, which allows air to escape from inside the lung and inflates the space between the lung and the ribcage. Pressure from this enlarging pocket of air causes the lung to collapse. Atelectasis is often caused by a pneumothorax, but it can be a complication of many respiratory problems and conditions.
A collapsed lung can occur spontaneously but most often occurs in hospitalized patients undergoing certain procedures and people who experience chest trauma. Certain lung diseases, such as chronic obstructive pulmonary disease (COPD), asthma, and cystic fibrosis, increase the risk of a collapsed lung, as does participation in certain activities, such as scuba diving and high-altitude climbing or hiking.
The characteristic symptom of a collapsed lung from pneumothorax is severe, sharp chest pain and difficulty breathing. Atelectasis symptoms include possible chest pain or pressure, cough, and difficulty breathing. Treatment for a collapsed lung includes procedures to re-inflate the affected lung, ease breathing, and increase oxygenation. In rare cases, surgery is required to repair the damaged lung. Remembering to take deep breaths every hour, if you are bedridden or have pain with breathing, can prevent atelectasis.
Left untreated, a collapsed lung can lead to serious symptoms.
Seek immediate medical care (call 911) for severe difficulty breathing, bluish coloration of the lips or fingernails, and severe sharp chest pain.
Seek prompt medical care if you are being treated for a collapsed lung but mild symptoms recur or are persistent.
Thoracoscopic lung resection for spontaneous pneumothorax
A 20-year-old patient came to the EMC Surgical Clinic with a common disease – bullous lung disease. At the first visit in August 2013, the patient complained of chest pain and shortness of breath, which suddenly appeared with little physical exertion. Computed tomography of the chest organs revealed spontaneous left-sided pneumothorax (air in the pleural cavity) with collapse (collapse) of the left lung; bullous lung disease was suspected with the location of bullae in the tops of both lungs.On an emergency basis, drainage was installed in the pleural cavity, the air was evacuated, the left lung was expanded.
Bulla is a thin-walled bladder filled with air, which forms mainly in the upper parts of the lungs. Bullae of the lungs can be either congenital, resulting from a violation of the development of lung tissue, and acquired, associated with impaired patency of the bronchioles and small bronchi due to various diseases. The alveoli overflowing with air gradually stretch, thin-walled cavities appear, which, slowly increasing, can reach large sizes.Bullous disease is usually asymptomatic, but often, as in the case of our patient, it is complicated by rupture of bullae and the occurrence of spontaneous pneumothorax.
The patient continued outpatient observation, felt well, but in November, in fact, two months after the first episode of pneumothorax, a relapse of the disease occurred. Repeated computed tomography clearly revealed the cause of pneumothorax – a bulla in the apex of the left lung (Fig. 1).
The patient underwent surgery: thoracoscopic resection (removal of a small part) of the upper lobe of the left lung, partial pleurectomy (removal of a part of the pleura).
The capabilities of the EMC Surgical Clinic allow performing most operations on the chest organs by thoracoscopic access, i.e. using video equipment and special instruments inserted through small incisions in the intercostal spaces. Open operations on the organs of the chest are often accompanied by prolonged and severe pain syndrome, the cause of which is the injury caused by the separation of the ribs.When using thoracoscopic technique, minimal tissue damage reduces the intensity and duration of postoperative pain syndrome, reduces the likelihood of postoperative complications and the length of hospital stay.
In our case, the operation and the rehabilitation period passed without complications, and the patient was discharged from the hospital on the 4th day after the surgery.
Spontaneous pneumothorax – treatment, symptoms, causes, surgery.
Spontaneous pneumothorax is the penetration of air into the pleural cavity from the environment due to a violation of the integrity of the lung surface. It is customary to distinguish between primary and secondary (i.e. associated with any lung disease) pneumothorax.
Spontaneous pneumothorax develops, as a rule, in young men, in women it occurs 5 times less often. The first moment from the development of pneumothorax, patients often complain of pain in the chest on the side of the pneumothorax of a stabbing or aching nature, a feeling of shortness of breath, a cough, usually dry, a decrease in exercise tolerance.An increase in body temperature often appears after a few days. The diagnosis is often not difficult for an experienced specialist. With plain chest x-ray in two projections, in most cases, it is possible to establish a diagnosis.
Small pneumothorax does not require surgical intervention, however, patients should be hospitalized for observation, pain relief, oxygen therapy. Within a few days, air from the pleural cavity with a small pneumothorax is absorbed independently.With medium and large pneumothorax, drainage of the pleural cavity is necessary. This procedure is performed under local anesthesia with the patient on the “healthy side”. Through the intercostal space, a drainage with a diameter of 6 mm is installed into the pleural cavity. During the drainage of the pleural cavity, it is possible to perform diagnostic thoracoscopy, i.e. examination of the pleural cavity and lung, in order to identify changes that led to pneumothorax. In most cases of primary pneumothorax, the cause of the defect in the lung is the rupture of an air bubble on the surface of the lung (bulla).
Bullae can also occur in healthy people and do not necessarily lead to the development of pneumothorax. The cause of secondary pneumothorax is a disease of any lung, leading to the destruction of lung tissue. Such diseases include chronic obstructive pulmonary disease, bronchial asthma, lymphangioleiomyomatosis, disseminated processes in the lungs, cystic fibrosis and others.
When the lung expands and the air supply stops, drainage is removed.If the lung is not straightened or the defect persists in the lung, surgery is necessary.
The risk of recurrence of primary spontaneous pneumothorax is usually about 30% after the first episode. After the second, about 60%, and after the third, about 80%. Therefore, in most clinics, recurrence of pneumothorax is an indication for surgery.
Surgery for spontaneous pneumothorax is performed under general anesthesia. The purpose of the operation: sealing the defect in the lung, marginal resection of the lung tissue, removal of the pleura (the membrane lining the inner surface of the chest wall) to create adhesions between the lung and the chest wall in order to prevent repeated pneumothorax.Surgical intervention in 97-98% helps to prevent subsequent relapses of pneumothorax.
Surgical intervention is performed using endoscopic technique from 3-4 small incisions 1-1.5 cm in size. The duration of the operation is 40-50 minutes. Patients are discharged from the hospital 3-5 days after the operation.
Diagnostic and therapeutic tactics for spontaneous pneumothorax, used in our Center, corresponds to the “Protocols for the provision of therapeutic and diagnostic care for acute diseases of the chest cavity (spontaneous pneumothorax)” approved by the St. Petersburg Association of Surgeons in 2007.
Protocol of standards for spontaneous pneumothorax
Spontaneous pneumothorax – guidelines
To make an appointment with a doctor about the diagnosis and treatment of spontaneous pneumothorax in our center –
call tel .: +7 952 3598179 – St. Petersburg (St. Petersburg).
Ask a question online for the treatment of spontaneous pneumothorax
Emergency cardiology.Part 1 Pulmonary edema and cardiogenic shock
The first diagram shows the alveolus, which is surrounded by the interstitial space, to which the vessel is adjacent. Gas exchange occurs between the vessel and the alveolus. If pulmonary edema develops, then the pressure in the vessel increases.
If the cause of pulmonary edema is myocardial infarction, then the pumping function of the heart is impaired. The heart stops pumping blood, therefore blood stagnation develops in the left atrium, then blood stagnation in the vessels of the pulmonary circulation, the vessels overflow, the hydrostatic pressure increases.And at a certain moment, the vessel can no longer hold the excess pressure and this fluid begins to sweat and enters the interstitial space – this is a kind of barrier to the path of this fluid into the alveoli.
The interstitial space begins to work as a drainage, maximally absorbing this fluid and removing it through lymphatic drainage. Thus, the alveolus is protected.
At this stage, the patient suffers from shortness of breath – cardiac asthma. If the situation is safely resolved (for example, the hypertensive crisis is arrested) and the hydrostatic pressure in the vessels decreases, then all pathological processes end.If it is a myocardial infarction and the heart continues to be in the infarcted focus, this condition progresses.
The interstitium is no longer able to cope, its compensatory capabilities are limited. The interstitium can compensate up to 300 ml of fluid. But if the pulmonary edema continues to develop, the possibilities of the interstitium end and fluid enters the alveolus. A catastrophe is developing here.
The alveolus is lined with surfactant from the inside, which maintains its airiness and prevents it from sticking together.And the alveolus retains the shape of a bubble. If liquid gets in, this medium is not typical for the alveoli, the surfactant cannot exist in the liquid medium, it begins to break down. The alveoli stick together and thus the lungs lose some of the alveoli.
At the macro level, the patient’s respiratory surface decreases. He begins to choke, his shortness of breath progresses, and a cough begins. The sputum is frothy with red streaks, because together with the liquid part of the blood, trace elements (erythrocytes) sweat and stain the sputum red, and the frothy sputum – the patient continues to breathe, he convulsively grabs air and this flow of oxygen, which enters the lungs and meets with liquid partly, acts as a mixer, foams this liquid.
The respiratory surface drops rapidly, because the alveoli collapse, the lungs are flooded.
Collapse of the trachea.
One of the common reasons a dog owner has to go to a veterinarian is a prolonged cough, which can be caused by a genetic disorder such as tracheal collapse.
This disease is typical for dogs of small breeds, such as: Chuhuahua, Russian Toy, Japanese Chin, Miniature Poodle, Pomeranian or Pomeranian, Yorkshire Terrier, Pug and others.Tracheal collapse is diagnosed in dogs of all ages (from 1 to 15 years). Middle-aged and elderly dogs, as well as overweight and living in a house containing irritating substances in the air – tobacco smoke, dust, etc., are more often at risk. Cases of tracheal collapse have also been reported in cats.
Tracheal collapse is a chronic, progressive disease of the lower airways of the respiratory system – the trachea. The trachea is a flexible tube that conducts air from the larynx to the bronchi; in dogs, it is a cylinder compressed dorsoventrally.It is based on small open hyaline cartilaginous rings that maintain the lumen of the organ open during inhalation and exhalation. They have a “C” shape, where the non-fused part of the cartilage is directed dorsally and their ends are connected to each other by tracheal ligaments (transverse membranes), over which the tracheal muscles pass, connecting the cartilages themselves.
With tracheal collapse, the hyaline cartilage of dogs loses its rigidity, begins to thin and sag, as a result of which the tracheal ligaments and muscle stretch, sag (prolapse) and become mobile, and the lumen of the tube itself becomes C-shaped.
The reason for such structural changes in the trachea is not fully understood, but is likely multifactorial. Loss of cartilage strength is associated with a deficiency of cellular components of normal hyaline cartilage. Studies carried out by foreign experts have shown that in the canine collapsed tracheal cartilage there is a decrease in the amount of glycosaminoglycans and glycoproteins for binding water, which leads to an uncharacteristic decrease in the stiffness of the tracheal ring, a decrease in the content of chondroitin sulfate and calcium.These deficiencies result in the replacement of normal hyaline cartilage with collagen and fibrous cartilage, which in turn leads to subsequent weakening of the rings and collapse.
The most common site of tracheal collapse is at the entrance to the chest cavity, where the cartilage is thinnest. Also, weakened cartilage can lead to “collapse” not only of the trachea, but also of the bronchi themselves.
The severity of collapse varies from minimal to almost complete occlusion of the tracheal lumen and manifests itself in the following stages: I – closure of the lumen by 25%, II – by 50%, III – by 75%, IV – complete closure of the lumen (Fig.1). Without constant monitoring and treatment, pathology can progress from stage I to stage IV.
Fig. 1. Stages of progression of tracheal collapse.
In most cases, signs of respiratory pathology were noticed by the owners for at least two years, but were not as pronounced as at the time of the visit to the doctor. The clinical symptoms of tracheal collapse are:
- Dry, barking cough;
- Cough on palpation of the trachea or on lifting an animal;
- Shortness of breath;
- Hoarse noise on inspiration;
- Inability to prolonged physical activity;
- Vomiting while eating and drinking.
Medical history, as well as clinical signs, often indicate collapse of the trachea, but a thorough diagnostic assessment is necessary to exclude other diseases of the patient’s respiratory system, for example, elongated soft palate, chronic bronchitis, infectious tracheobronchitis, foreign body entry into the airways, and others.
In general, the following investigations are recommended:
1. Taking anamnesis.
2. Clinical and biochemical blood tests.They are necessary to determine the general condition of the animal and to identify inflammatory processes that contribute to the aggravation of the collapse.
3. Radiography. The most informative is the lateral radiographic projection of the entire trachea during the maximum stage of inspiration and expiration. Some authors also recommend a tangential, horizontal view of the thoracic opening of the trachea.
4. Fluoroscopy. Allows in real time to assess the trachea and bronchi in various states of the respiratory system (when inhaling, exhaling, coughing) (Fig.2).
Fig. 2. Fluoroscopy of a dog with collapsed trachea (green arrows) and bronchi (red arrows).
5. Ultrasound. Ultrasound is used to demonstrate the reshaping of the tracheal lumen on ventrodorsal projection in dogs with collapsed cervical trachea.
6. Tracheobronchoscopy. This endoscopic view of the inside of the trachea using a fiber-optic camera provides the best detailing of the airway from the inside and allows you to collect fluid samples for cytological examination (Fig.3).
Fig. 3. Tracheobronchoscopy of a dog with stage IV tracheal collapse.
7. ECG. Cardiac ultrasound to assess cardiac function and contraindications to anesthesia.
Medical therapy and surgery have been successfully used by physicians around the world to treat tracheal collapse.
Drug therapy forms the basis of treatment for most dogs with collapsing trachea. Antitussives reduce the main clinical signs of tracheal collapse (cough).Antibiotic courses are used to prevent the worsening of the collapse of the trachea as a result of inflammatory processes, the frequency of which increases due to a violation of the protective function of the respiratory system. Drugs to reduce airway pressure (glucocorticoids, bronchodilators) are also used and may be particularly indicated for dogs with stage I airway disease and intrathoracic tracheal collapse.
Animals with tracheal collapse are often presented with respiratory distress and in an unstable state, as they show severe anxiety due to respiratory failure, therefore the main task of the doctor is to minimize stress until the patient can breathe comfortably.This is achieved by oxygen therapy using invasive means (such as an oxygen mask), as well as sedating and calming the patient to help relax, balance breathing, optimize inhaled air volume, and improve ventilation.
If drug treatment does not give results, as well as at stage IV of collapse of the trachea and during the transition from stage III to IV, surgical intervention is indicated. This may involve surgical placement of plastic rings around the outer surface of the trachea, thereby aligning the collapsed wall (Fig.4.5). Another option is stenting (Fig. 6.7). A stent-spring device is placed in the tracheal lumen without a surgical incision to keep the tracheal lumen open.
Fig. 4. Tracheal plastic rings of different sizes.
Fig. 5. Rings (green arrows) installed in the trachea
Fig. 6. Stents of various sizes.
Fig. 7. A stent in the trachea.
Lifestyle changes are always part of therapy for dogs.This is limiting physical activity, especially in hot weather, a strict diet to reduce the dog’s weight, removing smoke and other irritating substances from the environment.
The owner must remember that it is impossible to completely cure the animal from the collapse of the trachea, but control over the clinical signs of the disease, regular examinations and adherence to the doctor’s recommendations are the key to a long and healthy life of the pet.
90,000 Cough in dogs | “VetMedCenter”
Cough is a defense reaction (reflex) of the body against irritants (viruses, bacteria, chlamydia, dust, foreign bodies, smoke, chemicals, irritating gases, molds, mites, etc.).of the mucous membrane of the respiratory tract (from the pharynx and trachea to the area of the tracheal bifurcation, i.e. not including the small bronchi), which has corresponding receptors.
Owners often find it difficult to distinguish cough from vomiting. It is necessary to understand what came first: cough or vomiting. With a debilitating cough, vomiting sometimes occurs, while the acidic contents of the stomach, getting on the mucous membranes of the pharynx, further irritate the receptors of the mucous membrane of the respiratory tract, thereby further intensifying the cough.
To establish the cause, doctors conduct:
1. General examination and collection of anamnesis. When collecting anamnesis, cough is classified according to the type of manifestation, the severity of the course, and the duration. By the type of manifestation, a productive and non-productive cough is distinguished. The severity of the course of the cough can be determined by massage of the trachea, depending on the severity of the cough reflex, a regular uncomplicated, paroxysmal and suffocating cough is distinguished. By the duration of the cough, it is possible to determine the acute and chronic course of the disease, in which there are three categories of cough: stable, progressive and recurrent.Sometimes the time of onset of cough may also indicate a more likely pathology. So a nighttime cough in dogs may indicate diseases such as heart failure, pulmonary edema, or tracheal collapse. During a clinical examination, the condition of the nasal passages, the color and condition of the mucous membranes, examination of the oral cavity (including the area of the pharynx and the root of the tongue, tonsils), lymph nodes, tracheal reflexes, auscultation of the heart, lungs and trachea are assessed.
2. Roentgen (in frontal and lateral projection ). Veterinarians identify many diseases of the respiratory system: narrowing of the trachea, assess the silhouette of the trachea, identify hydrothorax, neoplasms, foreign bodies, assess the condition of the lungs (compaction, fluid stagnation, pulmonary edema).
3. Clinical blood test – necessary, in view of monitoring systemic inflammation in connection with a disease of the respiratory system.
The root cause of the cough:
1. Pathology of the upper respiratory tract.Such as inflammation or irritation of the paranasal sinuses, the root of the tongue, pharyngitis, otitis externa. Tonsillitis is more common in puppies and small dog breeds, as well as cats. In diseases of the larynx or trachea, the cough is usually short to hacking, but strong and loud. If the vocal cords are affected, the cough is hoarse. On auscultation, noisy, loud breathing and wheezing often indicate a pathology of the trachea or nasal passages.
With peritonitis, heart failure, and even with pulmonary edema or chest trauma, cats will not develop a cough.
2. Due to the lengthening of the soft palate, due to the retraction of the palatine curtain with the development of laryngitis in brachycephalics (ie, breeds such as Pekingese, Pugs, Bulldogs, Lhasa Apso, Shih Tzu and some Persian-type cats), a cough may also be observed, which is usually more intense during the heat and increased physical activity, which is associated with increased tissue edema and tachypnea.
3. Mechanical pressure on the trachea manifested at the moment of excitement, physical exertion or when the collar pressure increases on the trachea.
4. When the trachea collapses, the cough is often stimulated by drinking water. If a cough occurs while eating (or shortly after), then it is necessary to exclude diseases of the larynx and esophagus, this is possible with tracheitis. Tracheal collapse is considered a genetic disorder in mainly dwarf dog breeds and is more common in middle-aged dogs, especially if they are overweight. Diagnosis of tracheal collapse is not always easy, sometimes several X-rays are required to get into the desired phase of breathing, but if the diagnosis is not so obvious, then bronchoscopy is necessary to confirm it.If a puppy under six months of age has symptoms of cough similar to tracheal collapse, then tracheal hypoplasia should be excluded, in which the cough is usually less pronounced than with collapse, but shortness of breath is more pronounced. Tracheal collapse does not occur in cats. Sometimes bronchoscopy is performed to accurately determine the degree of collapse of the trachea.
5. Foreign body in the larynx or trachea. The cough in this case will be sudden, sharp, persistent and often suffocating, always in combination with shortness of breath.In the presence of a foreign body in the pharynx or esophagus, an acute and regular cough is also observed, as a rule, not complicated. It can be differentiated by the presence of salivation, urge to vomit and impaired swallowing. With a single sporadic cough, the ingress of foreign substances into the airways (large dust particles, food particles, drinking water, grass, insects, seeds) is first of all excluded. When a foreign irritant gets in, if the body was able to remove it itself for some time, excitement and weaker coughing fits may still persist.However, if the attacks of coughing significantly increase and become more frequent, then it is necessary to urgently conduct a chest X-ray to identify a foreign body in the esophagus or pharynx. Sometimes, to identify a foreign body in the esophagus or pharynx, it is necessary to resort to endoscopic examination, since finding a foreign body in the area of the cardiac sphincter can also give a false symptom of a cough, which is actually an unproductive urge to vomit. If foreign bodies enter the lower respiratory tract, a severe infectious process occurs, i.e.e. pneumonia.
6. Infectious causes. Often, owners begin to assume the presence of a foreign body in the airways due to the fact that the pet coughs them as if it choked. However, it often looks like a cough of an infectious nature. In this case, there may be other accompanying symptoms: fever, lethargy, decreased appetite, discharge from the nose of the eyes, swollen lymph nodes, etc. It is important to consider the infectious etiology of cough in outdoor animals that have contact with other animals, such as in pet shops, dog playgrounds, exhibitions, animal hotels, and especially animal shelters.So after contact with an infected animal, the development of clinical symptoms of an aviary cough in a dog should be expected both within 2 days and even after 3 weeks. The determination of the etiology of cough is also influenced by the age and breed of the animal. Younger animals are more prone to infectious diseases.
7. For cardiac pathology. Cardiogenic cough occurs in older dogs, in addition to coughing, there will be shortness of breath and general lethargy and weight loss in the animal. On auscultation, you can hear arrhythmia or heart murmurs, which is a direct indication for ultrasound of the heart.However, in large breeds of dogs, heart murmurs are weaker or not at all auscultated. Cardiogenic cough can be observed with congestion in the cardiovascular system or with heart disease (myocarditis, myocardosis, HCM, DCM, etc.). In small breeds of dogs, mainly age (10 years and older) and especially in dachshunds, mitral valve insufficiency is most common. Cardiogenic cough is associated with an enlargement of the left atrium in dogs, which pressing on the left bronchus will irritate its receptors, which sometimes leads to a persistent and even debilitating cough over time.It usually manifests itself especially during physical exertion. Clinically, animals look emaciated, shortness of breath and fatigue are often observed, and cyanosis of the mucous membranes can be observed. It is believed that in cats, cough does not occur with cardiogenic pathology, because the heart size of cats is small enough that even an enlargement of the left atrium will not result in bronchial pressure. In larger dog breeds, such as Dobermans, Labradors, and Boxers, cardiogenic cough is associated with the development of dilated cardiomyopathy.Symptoms will develop quickly. Abdominal ultrasound can show ascites and hepatomegaly, which are more specific for dogs, as an indirect sign of heart failure.
8. Cancer cause. Tumors are more common in older animals and can be either primary or secondary. Most of the neoplasms in the chest are secondary metastatic in nature. For example, in older dogs, breast tumors can metastasize to the lungs.
9. Parasitic etiology of cough. Hookworm and toxocar larvae during the period of large migration can cause cough symptoms due to the development of tracheobronchitis. But this pathology occurs more often only in young animals, especially up to one year of age. The vectors of dirofilariasis are mosquitoes, the infestation occurs in dogs and very rarely in cats.
Infectious Causes of Cough in Dogs
Kennel cough dogs can be caused by a variety of infectious agents, such as parainfluenza, reovirus, adenovirus 2, herpes virus, secondary bacterial infections (streptococci, staphylococci, pasteurella, klebsiella, mycoplasma, tuberculosis), etc.Mainly animals get sick in crowded groups (kennels, shelters for stray dogs), as well as after various mass events with the participation of dogs (exhibitions, etc.). Infection occurs by airborne droplets. The main symptom of the disease is a convulsive, dry cough, combined with nasal discharge and fever, often accompanied by hyperemia of the pharynx mucosa and soreness of the tonsils. With kennel coughs, sneezing, nasal and eye discharge are common clinically in dogs.It is also possible just a separate nonspecific bacterial tracheobronchitis. If the disease has already become chronic, then due to the quietness and weakness of the cough, it can be overlooked. The muffled sound of a cough is due to the fact that due to a decrease in the elasticity of the lung tissue, air is removed from the respiratory tract more slowly.
With bronchopneumonia, cough has an acute course, at first it is dry, then with the accumulation of catarrhal exudate it becomes moist. According to the severity of the course, it can be different (from rare to paroxysmal), but more often not complicated.In this case, there may also be fever, lethargy, loss of appetite, shortness of breath. Congestive humid murmurs in the lungs indicate this more severe course of the disease (pneumonia, fluid accumulation in the lungs).
With pneumonia , as well as with pleurisy, there is a decrease in respiratory noise. With pneumonia, wheezing can also be auscultatory. In severe cases, there may be changes in the clinical analysis of blood (neutrophilia, leukocytosis, increased ESR). With pleurisy, cough is usually quite rare and not pronounced, due to pain in the chest when the animal tries to suppress the cough.Anorexia does not always indicate a severe systemic course of the infection, it may simply be a consequence of local pain in the form of tonsillitis, stomatitis, tracheitis, then the release of foamy sputum is also usually observed.
Infectious causes of cough in cats
- Infectious rhinotracheitis is rarely accompanied by a cough, mainly sneezing and conjunctivitis. the cause of the cough is not the herpes virus itself, but the secondary complications of the disease.The disease is also highly contagious and affects crowded animals. With infectious rhinotracheitis in cats, the cough is usually dry and has an acute and uncomplicated course.
Bordetellosis in cats is rarely severe and only in kittens can it lead to bronchopneumonia.
Fever, nasal and ocular discharge can also be observed clinically in cats with cattery coughs. In cats, coughing is extremely rarely accompanied by sputum, more often swallowing occurs with saliva.
Quite often, a cat’s cough has a primary non-infectious etiology, as, for example, with asthma . Asthma is more common in young to middle aged cats. In the presence of asthma, it is sometimes possible to note the seasonality of its course (for example, when reacting to pollen – during the flowering season). At the same time, the cough in cats has a chronic recurrent course. During the rest period, the cough is usually rare and dry, but at times it becomes regular up to paroxysmal exacerbation, i.e.e. suffocating.
In chronic bronchitis , the cough is similar to asthmatic, but does not show signs of suffocation. At the same time, slight eosinophilia may also be observed in the blood and moderate inflammatory signs may be present – neutrophilia, increased ESR. X-rays can reveal signs of cartilage calcification and a decrease in the airiness of the lungs. Chronic obstructive bronchitis can be considered as some intermediate condition between bronchitis and pulmonary fibrosis.
In case of suspicion of an allergic nature of cough, antihistamines and corticosteroids are used in a short course, in the case of feline asthma, the desired aerosol forms of steroids.
For successful treatment of cough, it is necessary to know its cause or at least establish it by excluding other possible diagnoses, therefore, at least when diagnosing a cough, a detailed history is collected, a thorough clinical examination is carried out, including auscultation of the trachea and chest cavity, chest X-ray and general blood test. The rest of the diagnostic measures will be assigned based on the data from the baseline examinations.
For any type of cough, the general recommendation is always humidification of the air (which will always help to some extent to facilitate breathing), good nutrition, keeping the animal warm and without stressful situations.During the period of exacerbation of the cough, it is desirable to transfer the animal to wet feed. It is not recommended to use antitussives as drugs of first choice, moreover, they are not effective as monotherapy, because suppressing the cough without affecting the cause itself can provide only temporary symptomatic relief. Also, as a complex treatment for cough, prophylactic deworming is usually prescribed.
In case of an infectious cough, it is not advisable to immediately use antitussive drugs, i.e.damping the cough, the body is weaker released from excess mucus, which, once in the lower respiratory tract, can lead to complications up to pneumonia. In view of this, expectorants should also be used with caution.
In case of frequent relapses of tonsillitis, it is important to treat the concomitant disease, to sanitize the oral cavity with the removal of diseased teeth.
Kennel cough in dogs can sometimes go away on its own within 1-2 weeks and without therapy, however, complications may develop.To avoid complications, antibiotic therapy and immunomodulators are recommended, especially for those dog breeds that are more prone to developing severe respiratory tract infections.
With a lingering cough of an infectious etiology, the development of tonsillitis, bronchitis, and even more so bronchopneumonia, a very long course of antibiotics is required, with a milder course – up to two weeks, and with a severe one – at least a month. In general, in the presence of a lingering cough, both in dogs and cats of any etiology, a course of antibiotic therapy is necessary.With chronic cough, especially with weak dynamics for antibiotic therapy, it is necessary to select antibiotics based on the results of bacteriological culture. It is important to remember that expectorants cannot be prescribed simultaneously with antitussives, because expectoration of sputum cannot be suppressed. In the treatment of cough in cats of infectious etiology, antibiotics, antiviral and immunomodulators, vitamin therapy are also used, and when the body is weakened, appetite decreases, hydration is also necessary (subcutaneous or intravenous, depending on the severity of the course).Local treatments are also prescribed (nasal sanitation, nasal drops for rhinitis, local antiseptics for stomatitis, eye drops for conjunctivitis).
The main means of preventing respiratory viral infections (and especially effective in dogs) is vaccination. And even in the case of infection, in the presence of vaccination, the course of the disease will be in a milder and short-term form.
With a prolonged cough due to the collapse of the trachea, antibiotic therapy is prescribed, in the absence of positive dynamics on it, steroid drugs (Prednisolone) are used in anti-inflammatory doses in a short course (usually no more than 5-7 days).
When using a collar, it is advisable to change it to a harness in order to reduce pressure on the trachea. During the period of exacerbation, it is necessary to control body temperature, avoiding hyperthermia and preferably the use of sedatives. In rare cases, in the absence of the effect of steroid drugs, it is possible to test the use of antitussives. In the presence of signs of respiratory failure, such as cyanosis, stridor and fainting, tracheal stenting is necessary, however, it does not relieve this symptom of cough and even sometimes worsens it due to irritation, i.e.because the mucous membrane of the airways reacts to the stent as a foreign body. For overweight dogs, it is important to follow a low calorie diet for weight loss.
If a parasitic cough is suspected, it is very important to carry out preventive deworming before mating and in pregnant bitches, in order to prevent the infection of puppies with helminthiasis during lactation.
In the treatment of cardiogenic cough, it is necessary to use diuretics, adherence to a diet (with a reduced amount of sodium), as well as a frequent effect of antihypertensive drugs and other heart drugs.It is necessary to follow a diet low in salt and limit fluid intake. Physical activity is desirable to avoid.
In addition to systemic antibiotic therapy, bronchodilators and steroids are used in the neoplastic process in the lungs.
How to save a person in case of an accident (accident)
This is a difficult but important post. I will tell you what to do if you suddenly witness a serious injury or injury. The instructions in this post are reliable and have been tested by the military during conflicts, but the common man can find them useful in times of peace.We drive cars, go hiking, etc. – there are enough potential hazards.
The vast majority of people in war do not die from fatal injuries, but from a lack of primary health care. The statistics of causes of death will be distributed as follows:
– 60% of people die from blood loss
– 30% from pneumothorax (collapse of the lung)
– 8% from airway obstruction
– 2% from hypothermia
In each of these cases, it is possible and first aid is needed, which will save the victim’s life.Under the cut I want to tell you in detail about each case …
The first thing you should do when you see a wounded person is to find a first aid kit. The military has a number of rules on this matter. For example, each soldier should have his own first aid kit. If you were wounded, then they will treat you only with what they find in your first-aid kit. None of theirs will get anything for you. If you do not have a bandage or tourniquet, then this is your problem – no one will give theirs. Leave you to die.
A first aid kit should be nearby so that you don’t have to fumble at the bottom of your backpack and search.If you are in a public place, think about where the first aid kit might be: in cars, offices, etc.
The most important thing in a first aid kit is a tourniquet. It is he who saves in 60% of cases when it is necessary to stop the rapid blood loss. The military has special harnesses, such as in the photo. A plastic stick is used as a lever to tighten the tourniquet even more:
Trying to put the tourniquet:
The tension must be strong enough to compress the artery.It hurts:
You can check the tension with your finger. If it gets under the tourniquet, tighten even more:
Before applying the tourniquet, it is necessary, if possible, to squeeze the artery. For example, with a wound in the leg, the artery is pinched on the abdomen:
Done. The stick is fixed in a special tightening. It is necessary to indicate (or remember for an ambulance in civilian conditions) the installation time of the harness. The fact is that the tourniquet cannot be kept for more than 2 hours in the warm season and no more than 1 hour in the cold, otherwise gangrene will begin.
It is also important to remember: only doctors can remove the tourniquet after 15 minutes. During this time, blood clots are formed, which can scatter throughout the body and cause cardiac arrest:
If there is no tourniquet, you can use any cloth. Well, or effectively rip off your shirt, like in a Hollywood movie. Instead of a stick, for example, a pen or a telephone will do:
Exercises with a tourniquet have been devoted quite a lot of time. We tried to apply a tourniquet with a mask on the face that mimicked the conditions of complete darkness.In fact, it was necessary to perform this operation by touch:
In such conditions, its problems. Sergei, for example, lost a tourniquet, and it took a lot of time to find it:
Using a military turnstile is much easier than constructing a bandage from improvised means:
By the way, about special equipment: you can take a wounded man out of a dangerous place. different ways. For example, using such a belt. Ideally, you should throw it to the wounded from behind the shelter and he himself must wrap himself so that you just have to drag him:
The military can also shoot back:
The classes were very plausible. They brought us pig lungs, which are very similar to human ones. On them, we worked out the obstruction of the airways:
Unfortunately, in order to prevent tragedy in this case, we need a tool: tubes that will straighten the airways. You can’t make such a thing out of improvised means:
The tube is inserted into the nose. It is painful and unpleasant.A very strange sensation – you stick a tube into your nose, and you feel the other end of it in your throat:
Pneumotorex is when air accumulates in the pleural cavity and compresses the lung. This can occur as a result of injury to the chest, after which the person cannot breathe and dies from suffocation:
It is necessary to release air from the area around the lung and let it expand. First, you need to seal the wounds. For this, there are special plasters in the medicine cabinet.If the wound is through, it is necessary to glue it on both sides:
Then you need to pierce the chest to release the accumulated air. The prick should be between the ribs, 4 cm from the collarbone below, under the second rib:
Or stabbing between the ribs under the armpit:
Pierce the chest with a special needle. When movies use a plastic pen case for this, it’s bullshit. You cannot pierce such a thickness with plastic:
A tube with a needle allows you to pierce the chest and release air by pulling out the needle:
If the wound is in the neck, raise your arm and bandage the armpit with bandages. When the person then lowers his hand, the bandage squeezes the wound site:
And finally, the composition of the military first-aid kit:
– Tourniquet (tourniquet)
– Tissue that stops blood
– Airway tube
– Plaster to seal the wound in the chest
– Needle for puncturing the chest
– Scissors for cutting clothes
– Thermo blanket
After training we tried our hand at “practice”.
This was similar to the Red Tactics class I wrote about earlier:
I hope you never need this information. Take Care of Yourself and Stay Tuned!
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About influenza prevention. | SPb GBUZ “City polyclinic No. 122”
On the prevention of influenza. | SPb GBUZ “City Polyclinic No. 122”
Influenza is an acute viral infection with airborne transmission of the pathogen, characterized by an acute onset, fever, general intoxication and respiratory tract damage.
The disease begins acutely with a sharp rise in temperature (up to 38 ° C – 40 ° C) with a dry cough or sore throat and is accompanied by symptoms of general intoxication: chills, muscle pain, headache, pain in the eye area.
Catarrhal phenomena – runny nose, cough usually occur on 3-4 days, and sometimes immediately with a rise in temperature.
The general condition of the patient is characterized by weakness, lethargy, loss of appetite, dry mouth, pallor of the skin.
In patients at the peak of fever, neurological symptoms may occur: against the background of a pronounced intoxication syndrome, convulsions, delirium, and hallucinations appear.
In a mild course of the disease, these symptoms persist for 3-5 days, and the patient usually recovers, but severe weakness persists for several days.
A severe course of influenza is accompanied by damage to the lower respiratory tract with the development of pneumonia and signs of respiratory failure: shortness of breath or difficulty breathing at rest.
In severe forms of influenza, pulmonary edema, vascular collapse, cerebral edema, hemorrhagic syndrome may develop, and secondary bacterial complications may occur.
The influenza virus in the air remains viable and infectious for several hours, on surfaces – up to 4 days. The virus is highly sensitive to disinfectants from different chemical groups, UV radiation, high temperatures.
Influenza viruses mutate in the process of evolution, in connection with which new variants of the virus periodically appear, which cause pandemics with serious consequences for human health.
The main effective method of preventing influenza is vaccination , which, taking into account the mutation of the virus, should be carried out annually.
Vaccination is carried out in accordance with the National calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemiological indications, approved by the Order of the Ministry of Health of the Russian Federation of March 21, 2014 No. 125n, as amended on 16.06.2016 No. 370 n.
The effectiveness of the influenza vaccine is incomparably higher than all non-specific medical preparations: it provides protection against those types of influenza virus that are most relevant in this epidemic season and are included in its composition.Preventive vaccination is economically justified as it reduces the incidence of influenza among the working-age population.
The main goal of influenza vaccination is to protect the population from a massive and uncontrolled spread of infection, from an influenza epidemic. Vaccination is recommended for all groups of the population, but it is especially indicated for children from 6 months, people suffering from chronic somatic diseases, pregnant women, as well as people from occupational risk groups – medical workers, teachers, students, service and transport workers.Children are especially vulnerable to influenza due to insufficiently formed immunity. Influenza in children can be severe with the risk of complications. The spread of the virus in organized groups is happening rapidly. A child is more likely to become infected if the flu vaccine has not been given.
It should be remembered that the body needs 2-3 weeks to create post-vaccination immunity. There are few contraindications to vaccination. The flu shot should not be done in acute febrile conditions, during an exacerbation of chronic diseases, with increased sensitivity of the body to egg white.
During the period of an epidemic rise in the incidence, it is recommended to take non-specific prophylaxis measures:
– Protection of the body during the epidemiological season – a minimum of contacts, refusal to visit crowded places, wearing a mask;
– Strengthening immunity – full-fledged fortified food, feasible physical activity, hardening, elimination of stress, full-fledged work and rest, adequate sleep, walking on the street;
– Hygiene measures – adherence to personal rules, rinsing the nose, regularly ventilating the room, humidifying the air in the room during the heating season.
Follow the rules of prevention, get a flu shot and be healthy!
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