• Treatment of pneumothorax
  • Pneumothorax - the presence of air in the pleural cavity. There are spontaneous traumatic and artificial pneumothorax - see artificial Pneumothorax.
    Spontaneous (spontaneous) pneumothorax - the flow of air in the pleural cavity as a result of violation of the integrity of the lung tissue and pleura. Spontaneous pneumothorax occurs more frequently in the light of tuberculosis due to a breakthrough in the pleural cavity tuberculosis caverns or bolusno altered lung tissue with emphysema. Spontaneous pneumothorax may be partial or complete, unilateral and bilateral.
    Spontaneous pneumothorax is characterized by the appearance of acute chest pain ("as if his chest had been pierced by a dagger"), increasing shortness of breath, tympanitis in percussion, the weakening of breath when listening to the lungs; radiographically is determined by the air in the pleural cavity. For spontaneous P., in addition to the severity of the initial shock and severity of respiratory failure, is determined by the degree of infection of the pleura.
    Pneumothorax in children may occur when the inherent weakness of the pleura, malformations of the lung, when forced artificial breathing in newborns. In children older pneumothorax can occur in pneumonia, excessive physical strain.
    Patients with symptoms of spontaneous pneumothorax need of immediate hospitalization.
    Traumatic pneumothorax occurs in injuries of the chest, bronchus or lung. There are pneumothorax indoor, outdoor and valve.
    Closed pneumothorax develops when the flow of air in the pleural cavity through wound of the chest wall or damaged bronchi short. A small amount of air in the pleural cavity has little impact on the function of the respiratory and cardiovascular activities. In these cases, the clinical course is mild. Large indoor pneumothorax causes serious functional disorders spadenia easy and displacement of bodies of mediastinum. Sometimes the severity of clinical course is due to the traumatic shock and intrapleural bleeding.
    Open pneumothorax occurs when you have a wound holes in the chest wall and parietal pleura, through which the pleural cavity freely communicating with the external environment, so the air when breathing in, absorbed in the pleural cavity, and when exhaling is pushed back. When you open P. severe clinical course, which is caused by losing light and off it from the act of breathing, and mediastinal shift in the healthy side and move it every time you inhale and exhale (flotation mediastinum).
    When you open the pneumothorax observed: cyanosis, dyspnea, sometimes up to 40 - 50 breaths in 1 minute, pulse Ochsen, weak filling, blood pressure is lowered. The wounded man is, as a rule, on the side damage, densely covering the wound. When coughing from the wound the blood running with air bubbles. Around the wound subcutaneous emphysema (see). Percussion observed timpani, when hearing - impaired breathing; radiographically in the pleural cavity is determined air and liquid level - hemopneumothorax.
    Valve pneumothorax occurs in cases when the air is pumped continuously into the pleural cavity, and to emerge from it cannot; it is characterized by a progressive accumulation of air in the pleural cavity. Valve pneumothorax can occur at the closed trauma of the chest wall and spontaneously - at break of lung abscess or tuberculous cavities.
    In valvular pneumothorax intrapleural pressure may exceed atmospheric. The mediastinal shift leads to a significant violation of blood circulation, and compression of easy - to difficulty in breathing.
    In valvular pneumothorax the patient's condition is extremely serious: sudden shortness of breath, cyanosis of the person, pulse Ochsen, increasing subcutaneous emphysema chest, back, neck, face, abdomen, and sometimes and extremities. You often need urgent surgical aid.

    Pneumothorax (from the Greek. pneuma - air and thorax - chest, chest)- the accumulation of air in the pleural cavity. There are indoor and P. When the air enters the chest cavity from the outside (due to breach the history of the chest), there is an outdoor P. (trauma). The admission of air from the inside (in the result of damage to the lung and pleura) forms a closed P. Typically education in the pleural cavity gas bubble is accompanied by losing light due to the elasticity of the latter. It is also observed at the opening of the chest of a corpse and is accompanied by the expansion of it. For larger accumulation of air, there is a displacement of the chest first and foremost, mediastinum. It is important to consider that the introduction of 500 ml of air in the pleural gap at cardiac catheterization causes a decrease in the maximum systolic pressure in the pulmonary artery and right heart. The value of the gas bubble depends on the nature of the damage. When you open P., there is complete losing of light, at a closed - both partial and full. The accumulation of air and the amount of intrapleural pressure depend on the size and nature of damage to the lung. In some cases, the damage is insignificant, and after the formation of a gas bubble air flow is stopped. In other cases, the flow of air continues with each breath. In some cases, there is the so-called gate pneumothorax (valve), when the accumulation of air in the pleural cavity grows with every breath and hole acts as a valve. In such cases, intrathoracic pressure is quickly becoming positive, continuously growing and urgent help.