Pneumothorax: How to Treat a Collapsed Lung

Lungs are amazing organs. They allow us to breathe in the oxygen we need to live and breathe out a waste product called carbon dioxide. Each lung expands like a balloon when we inhale air, but what happens if the balloon won’t inflate? This is known as pneumothorax, more commonly called a collapsed lung. 

If you haven’t heard of it, you’re not alone. Pneumothorax is a rare medical condition, but it does occur for thousands of people each year.

Learn the causes of collapsed lungs, the symptoms and your options for treatment.

What is a collapsed lung?

Your lungs sit inside your rib cage (chest cavity). Each lung has a thin wrapping around the outside that keeps the air and gas inside the lung. If there is a leak or hole in the lung and the lining around it, this air will leak outside the lung and build up in the chest cavity.

“The chest cavity is a fixed space, like a box, and the air outside the lung will squish the lung and blood vessels as the air and gas fill the space between the chest wall and the lungs,” said Stephanie Worrell, MD, a thoracic surgeon at Banner Health in Tucson, AZ. “As the pressure and amount of air in this cavity increase, it puts pressure on your lung making it unable to expand when you breathe but also stopping the flow of blood to the heart—which can be life-threatening.”

What causes the lungs to collapse?

A collapsed lung can occur for many reasons, but most often it is the result of a fall or injury that causes a rib to break and tear the lung. 

“Any blunt injury to your chest can cause a lung collapse,” Dr. Worrell said. “This can be due to car crashes or falls or from medical procedures that involve the inserting of needles into the chest.”

Other known causes of pneumothorax include:

• Having underlying lung disease: cystic fibrosis, COPD (chronic obstructive pulmonary disease), lung cancer, idiopathic pulmonary fibrosis (IPF), whooping cough and asthma 
• Smoking cigarettes and marijuana
• Spontaneously, most often in those who are tall and thin
• Small air blisters (blebs) that develop on the top of the lungs and sometimes burst, allowing air to leak into the cavity

How do I know if my lung is collapsed?

A collapsed lung is treatable, but it can be life-threatening. Dr. Worrell said you should seek medical attention immediately—call 911 or have someone take you to the closest emergency room—if you have any of these symptoms:

• Sudden shortness of breath or difficulty taking a full breath
• Sudden, sharp chest pain or chest tightness
• Shoulder pain that gets worse when you breathe in (inhale)

More severe symptoms may also include a racing heart, skin discoloration (bluish color) due to lack of oxygen and weakness.

“It’s always essential to get prompt medical treatment for a suspected collapsed lung,” Dr. Worrell said. 

How is pneumothorax diagnosed?

Generally, a chest X-ray or CT scan (for more detailed images) is performed to confirm that a lung is collapsed.

What is the treatment for a collapsed lung?

“The goal of treatment is to relieve the pressure in your lung, allowing it to re-expand,” Dr. Worrell said. “Depending on the cause of the collapsed lung, another goal is to prevent it from occurring again. ”

For small tears, your provider might treat you by giving oxygen and monitoring you. Sometimes a collapsed lung can get better on its own within a few weeks with rest.

For larger tears, the excess air will need to be removed. 

“Often, a small chest tube is placed to remove the air and allow the lungs to re-expand,” Dr. Worrell said. “If it is the first time this has ever happened, that is likely all that is needed. If it happens more than once or you plan to have a high-risk career (as an airline pilot, scuba diver or professional weightlifter), then surgery is recommended.”

The small operation will permanently stick the lining of the chest to the chest wall (pleurodesis) so there is no longer a space for air to collect. 

Your provider may also give you instructions on breathing exercises, called incentive spirometry, to help expand your lungs and air sacs to prevent pneumonia.

Can I prevent a collapsed lung?

Unfortunately, there is no way to completely prevent pneumothorax since it can occur spontaneously or due to trauma. However, if you smoke or vape, you should stop. Smoking can increase your risk of getting a collapsed lung.

If you’ve had a collapsed lung before, you should also talk to your provider if you fly on an airplane often. Flying at an elevation of 8,000 feet or higher can be dangerous, as the pressure changes can cause your lungs to re-collapse.

Takeaway

A pneumothorax is a collapsed lung. It occurs when air leaks into the space between your lung and chest wall (rib cage). This air puts pressure on the outside of your lung and makes it collapse.

While it is a rare condition, it can be life-threatening. If you are experiencing symptoms or are concerned you may be at risk for developing a collapsed lung, talk to your health care provider. 

Are you experiencing symptoms and have concerns about a collapsed lung?

Schedule an appointment with a primary care provider.
Schedule an appointment with a pulmonologist.

If you have sudden chest pain or shortness of breath, call 911 or visit the Banner Health emergency department closest to you.

Related blogs:

• How Hyperbaric Oxygen Therapy Treatments Could Help You Heal
• The Best Ways to Protect Yourself Against Aspiration Pneumonia
• Breathe Easier: Treatment Options for Asthmatics

Pulmonology and Asthma

Collapsed Lung: Care Instructions | Kaiser Permanente

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Overview

A collapsed lung (pneumothorax) is a buildup of air in the space between the lung and the chest wall. The pressure of the air against the lung makes the lung collapse. Your lung cannot fully expand when you inhale. This causes shortness of breath and chest pain.

A collapsed lung is usually caused by an injury to the chest. It may also occur suddenly because of a lung illness, such as emphysema or lung fibrosis. A lung may collapse after lung surgery or another medical procedure. Sometimes it happens for no known reason.

Treatment can depend on the cause and severity of the collapsed lung. Treatment can also depend on whether the problem has returned. Some people stay in the hospital for treatment. In some cases, oxygen may be given (through a mask). It may heal with rest, but your doctor will need to check you. It can take several days for the lung to expand again. Your doctor may have drained the excess air from your chest with a needle or tube. Sometimes surgery is done to help keep the lung inflated.

The doctor will want to keep track of your progress. So you will need a follow-up exam to check your lungs. You may need further treatment if you are not getting better.

A collapsed lung may happen again. Watch for symptoms. If you have shortness of breath or chest pain, get medical treatment right away.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Get plenty of rest and sleep. You may feel weak and tired for a while, but your energy level will improve with time.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you have a bandage over your chest tube, or the place where the chest tube was inserted, keep it clean and dry. Follow your doctor’s instructions on bandage care.
• If you go home with a tube in place, follow the doctor’s directions. Do not adjust the tube in any way. This could break the seal or cause other problems. Keep the tube dry.
• Avoid exercise until your doctor says it’s okay.
• Do not fly in an airplane or scuba dive until your doctor tells you it is okay.
• Do not smoke or allow others to smoke around you. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You have severe trouble breathing.
• You have severe chest pain.
• You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

• You have new or worse trouble breathing.
• You have new pain or your pain gets worse.
• You cough up blood.
• Your chest tube comes out or is bent or blocked.
• You are bleeding through the bandage where the tube was put in.
• You have symptoms of infection where the tube was put in, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

• The skin around the place where the chest tube was put in is red or irritated.
• You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter Q132 in the search box to learn more about “Collapsed Lung: Care Instructions”.

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 performed. 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.

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 Thoracopulmonology Center by phone:

(044) 521 30 03

Pneumothorax – causes, symptoms of the disease, diagnosis and treatment of the disease

Spontaneous pneumothorax is one of the most dangerous and severe injuries. 10% are faced with it, and one in ten of those who have experienced lung collapse dies within the first day after the onset of the disease. We understand, due to the presence of air in the pleural cavity, and what needs to be done for those who are faced with this injury.

How does a collapsed lung occur?

The lungs are paired organs located in the chest. Between them and the ribs that limit the chest, there is a cavity called the pleural cavity. This cavity is lined with a pleura – a special serous membrane that protects the respiratory organs from external influences.

The pleural cavity is sealed. Normally, there is no air inside it, but there is negative pressure. Because of this, the lungs are straightened and can function normally. But sometimes the tightness of the pleural cavity is broken. Most often this occurs with injuries, certain diseases or operations on the chest.

Pneumothorax is a violation of the integrity of the pleural membrane of the lungs. As a result, the lungs are deformed and cannot perform their function. Often this process occurs spontaneously for no apparent reason.

When this phenomenon does not have an obvious cause, they speak of the development of spontaneous pneumothorax. With it, the integrity of the pleura is violated, air enters it. Due to depressurization, the lungs are compressed, their deformation occurs and their function is impaired. This manifests itself in the form of respiratory failure, pain in the chest. This condition is called a collapsed lung.

Pathology should be distinguished from a violation of the integrity of the main respiratory organ, when it is easily burst or pierced. This also leads to air entering the pleural cavity. This pathology usually develops due to injuries and illnesses and does not apply to spontaneous pneumothorax, so the tactics of treating this pathology should be different.

Several harmful factors can influence the development of a collapsed lung. These usually include:

• Consequences of diseases of the lungs, in which adhesions form in them.
• The lung diseases themselves, which lead to changes in the lung tissue.
• Smoking, including electronic cigarettes, which causes damage to the lung tissue.
• Excessive physical activity, which can provoke pleural tear and lung injury.
• A genetic predisposition that manifests itself in diseases such as Marfan’s syndrome and some others.
• Sudden pressure drops that occur when flying in an airplane, diving to great depths, or playing wind instruments.

Most often, pneumothorax occurs in thin middle-aged adult men. It rarely develops in women and children. This disease is recurrent: after the first attack, relapse occurs in 25% of cases. Moreover, the likelihood of a relapse increases with each new episode of the disease. Spontaneous pneumothorax develops both on the right and on the left.

Main types of pneumothorax

Pneumothorax is distinguished by the cause of its occurrence, the side of the lesion, the severity of the course, and some other signs. It is necessary to determine the causes of the pathology in order to properly carry out therapeutic and resuscitation measures.

Open pneumothorax develops against the background of external injuries of the chest and the appearance of holes in it. If a hole is formed in the lung, then a closed type of lung collapse develops. Depending on the lesion, right-sided, left-sided or bilateral pneumothorax is distinguished.

The disease can occur with or without complications, develop primarily as an independent disease, or itself be a consequence of other diseases. It may occur for the first time or be recurrent.

According to the severity of the course and localization of damage, there are:

By origin, they distinguish:

• traumatic pneumothorax;
• artificial pneumothorax;
• post-traumatic pneumothorax;
• valvular pneumothorax;
• limited pneumothorax;
• infectious pneumothorax.

These species are distinguished by the reason that led to its appearance. Traumatic and post-traumatic form develops due to direct trauma. Infectious include, for example, spontaneous pneumothorax in tuberculosis or pneumonia. To the valve – one that occurs due to a violation of the proper circulation of air in the lung.

Pay attention! Pain in the chest area can be a sign of a variety of pathologies, which include such serious illnesses as a heart attack. Therefore, if pain occurs, you should immediately consult a doctor or call an ambulance.

Main symptoms and signs

The main symptom of pneumothorax is a sharp pain in the chest area, which can radiate to the shoulder area. The intensity of the pain syndrome is individual and depends on other factors (state of health, mobility of the nervous system, etc.). Some simply note discomfort and a feeling of bloating in the chest.

The more air accumulates in the pleural cavity, the more pronounced the symptoms of lung damage. In addition to pain, cough, shortness of breath, pallor of the skin, tachycardia, rapid breathing, causeless lacrimation, dizziness appear.

These symptoms arise due to the fact that the lung collapses, it cannot perform its function completely and oxygen starvation develops. All organs suffer from it, but primarily the brain. The longer this condition lasts, the more serious the consequences.

Pneumothorax pain is often confused with other diseases, such as osteochondrosis, and the “wrong” disease is treated. Improper treatment leads to the fact that the patient develops complications that can lead to complete loss of the lung. Our doctors at a remote consultation will carefully study your medical history and help to exclude negative diagnoses

Complications of pneumothorax

The lungs are the first to suffer from pneumothorax. Their long gluing leads to adhesions, the development of a persistent inflammatory process (chronic pneumonia, obstructive pulmonary disease, and so on). If left untreated, abscesses can develop in the lung tissue, which can threaten complete removal of the lung.

If the air goes beyond the redistribution of the pleural cavity and enters other organs, emphysema develops in them. Most often, this complication occurs in the area of ​​​​the skin, heart and large vessels. In the latter case, this leads to their compression and can cause death.

Also, against the background of pneumothorax, respiratory failure often develops. Lack of oxygen affects all organs – from the brain to small vessels. The longer the organs do not receive a normal amount of oxygen, the more serious their damage.

In addition to air, fluid can accumulate in the pleural cavity. This leads to the development of hydropneumothorax, pleurisy and replacement of healthy connective tissues. This process is not reversible and significantly impairs the quality of human life. In addition, untimely treatment leads to constant recurrences of pneumothorax.

Disease diagnosis

Diagnosis is based on clinical symptoms, medical history, and examination. The doctor will definitely case the breath. With pneumothorax, it occurs auscultatively, that is, wheezing and noises in the chest are clearly audible in it. On external examination, the expansion of the intercostal space and the chest itself is noticeable.

To confirm and clarify the diagnosis, an x-ray of the lungs is prescribed. An x-ray image assesses the degree of collapse of the lung (the degree of its collapse) and the structure of changes in them, as well as some of the reasons due to which air entered the chest.

For more accurate diagnosis, other methods can be used – ultrasound and multislice computed tomography. Additionally, continuous monitoring of saturation is recommended to determine the degree of oxygen starvation.

Case study:

The man went to the ambulance with acute pain in the heart. He also complained that he could not take a deep breath. Initial examination revealed pallor of the skin, rapid breathing and tachycardia.

The patient was referred for an x-ray to rule out trauma, as well as an ultrasound of the heart to rule out a heart attack. The picture showed signs of collapse of the lungs on the background of chronic obstructive disease.

The patient was released from the pleural cavity, prescribed a treatment that helps to expand the lung and left under observation in the hospital.

Methods of treatment of pneumothorax

Treatment of pneumothorax is aimed at eliminating air from the pleural cavity, restoring lung function and preventing the development of complications, as well as preventing recurrence of the disease. In the treatment of lung collapse, conservative and surgical tactics are used.

Drug treatment is prescribed for minor stages of lung damage and no signs of respiratory failure. At the same time, analgesics are prescribed to reduce pain, as well as prophylactic doses of antibiotics to prevent the development of inflammation.

To remove excess air from the pleural cavity and restore lung function, a puncture is prescribed. The puncture is carried out on between 2 and 3, as well as 4 and 5 ribs. The needle is inserted under local anesthesia, so patients usually tolerate the procedure well.

With a severe course of the disease, multiple complications and the inability to do without surgical intervention, an operation is performed. A bronchoblocker is placed in the lungs, which prevents the lung from collapsing. Also, complete or partial amputation of the damaged organ is carried out.

If pneumothorax has developed as a complication of another disease or has been caused by injuries, excessive physical activity, or other conditions, these causes should be corrected.

If a pneumothorax is suspected, do not self-medicate and perform a puncture on your own. Without a certain experience, it is easy to damage the lung. Our doctors will remotely help you determine the cause of pain and, if necessary, call an ambulance.

Prevention of lung collapse

The prognosis in the treatment of the disease is usually favorable. If the patient complies with all the doctor’s prescriptions and leads a healthy lifestyle, a complete recovery occurs, and repeated attacks are rare.

To prevent primary pneumothorax, it is recommended to exclude the factors provoking it:

• timely diagnosis and treatment of pulmonary diseases;
• completely stop smoking;
• dose physical activity;
• try to avoid chest injuries;
• eat normally and avoid strict diets;
• compliance with the rules when flying and immersing in water.

Helps in the prevention of pneumothorax breathing exercises. It develops the lungs and prevents their injury. Also, such exercises help to avoid hypoxia during the attack itself.

FAQ

Why is pneumothorax dangerous?

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With pneumothorax, the integrity of the chest is broken and air enters it. Because of this, the lungs collapse, respiratory failure and other complications develop.

What treatment is recommended for hydropneumothorax?

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In the treatment of this disease, both conservative and surgical methods are used. Treatment is prescribed by a doctor based on the clinical picture and the severity of the course of the disease.

Who is most likely to develop pneumothorax?

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Most often, thin adult men suffer from pneumothorax. What this is connected with is not known for certain. In second place are women. Pneumothorax is rare in children.

Can pneumothorax be treated at home?

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No, treatment must be carried out under the supervision of a doctor in a hospital setting. With the rapid development of respiratory failure, the patient may require oxygen and urgent resuscitation.

What causes chronic pneumothorax?

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There is no such thing as chronic pneumothorax.