Pneumothorax is a disease in which air gradually builds up in the pleural cavity. This condition requires immediate hospitalization. This article provides information on the topic "Pneumothorax: what is it?", Discusses the causes and symptoms of pathology.
Disease Description
The human lungs function in full when the pressure in them is higher than in the pleural cavity. If, due to some reasons, air gets into the latter, this indicator increases markedly. The lungs respond to this violation by resizing, which causes shortness of breath and other symptoms caused by oxygen deficiency.
In medicine, this condition is called pneumothorax. It usually occurs in young people under the age of 40. When symptoms of a deterioration in the general condition of the patient appear, it is necessary to hospitalize urgently. Otherwise, the likelihood of life-threatening complications increases.
Causes and types of disease
How does pneumothorax develop, what is it? The disease occurs against the background of many reasons that determine its specific form. Based on this, doctors distinguish the following classification of pathology:
- Spontaneous pneumothorax. It develops for no apparent reason (primary) or against a background of ailments (secondary). It is usually diagnosed in men between the ages of 20 and approximately 40 years with a deficiency of body weight. At the heart of the disease is a hereditary predisposition or lung defect. In addition, pneumonia or tuberculosis can be the cause of this type of pathology.
- Traumatic pneumothorax. It develops as a result of an injury to the thoracic region, both from a penetrating wound and from internal damage. In the first case, air passes directly into the pleural cavity by means of an open wound, and then it is removed using it. In the second case, lung rupture is diagnosed . Thanks to this pathology, air freely enters the pleural region.
- Iatrogenic pneumothorax. It develops as a result of therapeutic or diagnostic manipulations (lung biopsy, puncture, catheterization).
The presented classification allows you to correctly diagnose "pneumothorax" and prescribe adequate treatment.
The clinical picture of the disease
Pathology begins its development with the appearance of acute pain in the chest area, which can give off to the neck or upper abdomen. Discomfort is felt during breathing or physical exertion. As the disease progresses, stiffness appears in the chest, a person feels a lack of air. This is due to increasing pressure in the pleural cavity and compression of the lung. Shortness of breath also appears, shallow breathing that does not bring the desired relief.
An acute lack of oxygen leads to pallor of the skin. In addition, there is a rapid heartbeat and excessive sweating.
Forms of pneumothorax
The presence / absence of a connection with the environment allows us to classify the disease in the following forms:
- Closed. It develops when air enters the pleural region. Clinically, this form of pathology is characterized by the mildest course. Small volumes of air can dissolve on their own.
- Open. There is an accumulation of excess air in the pleural cavity, which through the damaged bronchus or wound of the chest wall communicates with the environment. With each inhalation, air passes into the pleural cavity, and when exhaling comes out back. Pressure becomes equal to atmospheric, which entails the decline of the lung.
- Valve This form of pneumothorax is considered the most severe. If the wound is large, a complex valve structure is formed. When you inhale, air enters the pleural cavity, but when you exhale, it cannot go back. Its volume is gradually increasing. The disease leads to displacement and compression of the mediastinal organs, impaired respiration and blood circulation.
Depending on the volume of air in the pleural region, limited, medium and total pneumothorax are secreted. In the latter case, less than half of the normal volume falls on the lung.
Features of the disease in children
Pneumothorax in newborns can occur immediately after the first few breaths. In this case, we are talking about a spontaneous form of the disease. It develops with an uneven expansion of the lungs, which usually occurs due to malformations of the baby. In children under three years of age, this condition can be a complication of pneumonia. In adolescence, such a disorder occurs during coughing with the next attack of bronchial asthma.
Pneumothorax in children may not be clinically apparent. Sometimes short-term respiratory arrest is noted, in more serious cases - blueness of the skin, convulsions, heart palpitations. The principles of treatment are the same as in adults.
Diagnostics
A competent and timely diagnosis is extremely important in cases of suspected pneumothorax, since this condition often gives complications. To confirm the disease, a special role is played by the appearance of the patient, who usually combines all the symptoms of pathology described above. In addition, a person is forced to take a certain position (sitting or reclining position), then the pressure in the pleural cavity is not felt so much.
A physical examination is not enough to make a diagnosis, so patients are prescribed a chest x-ray with suspected pneumothorax. What it is? This study is highly informative and allows you to identify affected areas, the edges of a collapsed lung.
Radiography is not the only diagnostic method. If pneumothorax is suspected, computed tomography, a blood test for gases, and electrocardiography are also prescribed.
First aid
Pneumothorax is considered an emergency. Each person should be able to provide emergency assistance to the victim: reassure him, provide oxygen access, call a team of medical workers.
If there is open pneumothorax, the dressing is applied in such a way as to tightly close the defect in the sternum wall. In an emergency, in the absence of sterile materials, improvised means (shirts, shirts) can be used. The cleanest patch of tissue must be applied directly to the wound itself. To seal the affected area, cellophane or polyethylene is applied over the dressing.
With valvular pneumothorax, the patient requires pleural puncture to remove free gas, eliminate displacement of the mediastinal organs and expand the lung.
It is important to simplify the patient’s breathing process as much as possible. To do this, it must be laid on an elevated surface. In case of fainting, a person should be brought to his senses. When there is no ammonia at hand, it can be replaced by any means with a pungent odor (perfume, gasoline). After first aid, wait for the medical team.
Inpatient treatment
Patients with pneumothorax are required to be hospitalized. In a hospital, specialists do a puncture of the pleural cavity, due to which excess air is released. Treatment directly depends on the specific form of the disease.
Conservative therapy is relevant if it comes to closed small pneumothorax. The patient needs to ensure bed rest, if necessary, prescribe painkillers.
In the total version of the disease, a drainage is installed in the pleural cavity. This is necessary to prevent a shock reaction and restore the lung.
If the patient has open pneumothorax, assistance provided before the arrival of the medical team will save the patient's life. The main task of doctors is to translate the pathology into a closed form. To do this, the wound is sutured, as a result of which the penetration of air into the pleural cavity is stopped. The following are manipulations similar to those required for a diagnosis of closed pneumothorax.
After surgery, the patient is advised to completely abandon physical activity within four weeks. Flights by plane are prohibited for 14 days from the date of treatment. Doctors advise against diving and other active sports. All this causes pressure drops.
Prognosis after treatment
The outcome of the disease largely depends on the age and gender of the patient, the presence of complications and associated ailments. Spontaneous pulmonary pneumothorax, arising against a background of hereditary predisposition, is characterized by a favorable outcome.
In 20% of cases, patients have a relapse of the pathology, especially if it is caused by a primary disease. A condition of a person is considered dangerous when the pleural cavity is filled with air from two sides. This usually entails acute respiratory failure and death. The bilateral form of pneumothorax is characterized by a favorable outcome in only 50% of cases. This indicator is strongly influenced by the timeliness and quality of first aid.
Complications of pneumothorax
About half of the victims of this disease develop various complications. Among them, the most common is bleeding into the pleural cavity, which in most cases has a favorable outcome. With extensive blood loss, doctors record the death of the patient. Even if it is possible to normalize the patient's condition, the risk of heart and respiratory failure increases. Both of these conditions are life threatening.
In the traumatic variant of pneumothorax, there is a risk of infection of the wound and the formation of subcutaneous emphysema. Air gradually enters the subcutaneous fat, which is already a dangerous condition. Another complication of this pathology is inflammation of the pleura. It is accompanied by a vivid clinical picture and requires thorough treatment.
Preventive actions
There are no specific methods for the prevention of the disease. To prevent this pathology, doctors recommend adhering to a healthy lifestyle, abandoning bad habits, treating illnesses in a timely manner and spending more time in the fresh air.
From the materials in this article, you learned why pneumothorax develops, what it is, what its main symptoms are. When the primary signs of pathology appear, one should not panic. Pneumothorax is not a sentence; most patients successfully cope with such a diagnosis. Timely and high-quality treatment allows you to stop the pathology, prevent the development of complications.