Pneumothorax

Content


Pneumothorax
Pneumothorax
- Accumulation of air in the pleural cavity. Violation leads to sealing
atelectasis exhale that prevents breathing and can cause
mediastinal displacement - condition, threatening the patient's life.


Kinds
pneumothorax and the reasons for its development

AT
Depending on the penetration of air into the pleural cavity causes are distinguished:

  • traumatic
    (As a result of chest injuries);
  • spontaneous (sudden break
    pulmonary pleura);
  • iatrogenic
    pneumothorax (as a result of medical procedures).

Spontaneous pneumothorax
is a complication of various diseases such as tuberculosis, chronic
obstructive lung disease, lung cancer. By the development of iatrogenic pneumothorax
can cause a puncture of the pleural cavity, the subclavian vein catheterization,
endobronchial biopsy, barotrauma during mechanical ventilation.

By
presence of contact with the external environment pneumothorax is 3 kinds:

  • open;
  • closed;
  • valve.

In closed pneumothorax, pleural cavity does not communicate with the external environment,
and the air trapped therein, no change in volume.

at
open pneumothorax message has, as a result of air during inhalation
sucked into the pleural cavity, and on the exhale its excess emerges.

Valve
pneumothorax - the most dangerous option. In this case, at the injury site occurs
valve which opens the intake air to breath and closes on
exhalation. With each breath between the sheets of pleura accumulate more air,
he draws in easy to root, the mediastinum shifts that may violate
cardiac activity. Develops tension pneumothorax: pressure
pleural cavity exceeds the atmospheric pressure, the valve stops functioning,
squeezed healthy lung.


evidence
pneumothorax

Pneumothorax
After an injury, severe coughing appear sharp, stabbing pain in the affected
half of the chest, feeling short of breath, breathing becomes frequent and
deep. Man tends to take a forced situation (inclined to
affected side, patient lying on the side). The affected half of the thorax
lags in the breath, while a healthy working hard. When penetrating
injury of the chest can be observed accumulation of air in the subcutaneous tissue
(Subcutaneous emphysema), a pressure-sensitive skin audible crepitus (a distinctive sound,
similar to a crunch).


First
Help with pneumothorax and surgical treatment

at
suspected pneumothorax an urgent need to call an ambulance.
First Aid is in place. It provides the victim rest. Open
pneumothorax need to be translated into a closed, sealed putting bandage (from
oilcloth, plastic film).

at
suspected pneumothorax valve is necessary to reduce the pressure in the pleural
cavity by puncturing it. The puncture is made after medical needle
disinfecting the skin with alcohol on the upper edge at the third rib
intersection with a line drawn from the middle of the clavicle to nipple. The needle is inserted
perpendicular to the skin to hiss (the air enters the lumen of the needle). this
manipulation is not necessary to carry out, having no experience, but in cases of stress
pneumothorax puncture can save the life of the patient.

Treatment
closed pneumothorax in the hospital is reduced to drainage
pleural cavity using Bobrov apparatus. When you open a traumatic
pneumothorax shows emergency surgery for the repair of the defect lung injury
chest wall. When you resort to spontaneous pneumothorax thoracoscopy - study
pleural cavity through a puncture of the thorax. It helps to detect
cause pneumothorax, such as emphysema bullae lung, subpleural
cavities in tuberculosis.

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