What's the Least Painful Pneumothorax Treatment?
Therapies and Methods Used by Physicians to Correct a Collapsed Lung
Sep 24, 2009
A pneumothorax is a serious medical condition that prevents the proper expansion of the lungs inside the chest cavity. It refers to the accumulation of air inside the fluid filled volume, known as the pleural cavity, that surrounds the lungs. It often results in a collapsed lung.
If the condition is left untreated, it can progress to a life-threatening tension pneumothorax capable of causing sudden cardiac arrest. The recommended treatment depends on the severity of the pneumothorax and whether it is a recurring condition.
Treatment of a Small Pneumothorax May Not Require Surgery or a Chest Tube
The degree of a pneomothorax is usually gauged by the percentage of total lung capacity that a person is capable of utilizing. A 20% collapsed lung indicates that the patient has the use of 80% of the normal capacity in the affected lung. There is no firm delineation between a small and a large pneumothorax, but generally, any collapse of less than 5% is considered to be small.
Small pneumothoraces are usually of the spontaneous variety and are often given a chance to resolve on their own without the use of invasive medical procedures. The healing process can be observed with X-rays. The pleural cavity is capable of absorbing small amounts of air once the lung heals itself and the airtight seal is restored. For more information, see What Does Spontaneous Pneumothorax Really Mean?.
Surgery and a Chest Tube Is Needed to Correct A Large Pneumothorax
If a pneumothorax is too large to heal itself, the air pressure inside the pleural cavity must be relieved. To do this, a local anesthetic is applied to the interior of the chest wall using a syringe. The inner chest wall and the adjacent pleural surface are highly sensitive tissues capable of causing a person great pain. The inner surface of the pleura and the lung itself are comparatively insensitive.
Once the patient has been anesthetized, an incision is made between the ribs and the chest wall and a chest tube is inserted into the pleural space where air has accumulated. This tube is then connected to a device containing a one-way valve or a vacuum which will drain the air from the pleural cavity and allow the lung to re-expand. This procedure is called a tube thoracostomy.
The re-expansion of the lung is monitored with chest X-rays. Once the lung has recovered its full capacity and no air leaks are observable, the chest tube will be removed. If the lung retains full expansion after the removal of the chest tube, the patient will be allowed to go home.
When to Employ a Pleurodesis to Attached the Pleura to The Chest Wall
However, if the lung continues to leak once the chest tube has been inserted, or if large vulnerable blebs can be seen, in X-rays, on the surface of the lung, a pleurodesis procedure may be recommended. This treatment is also used in cases of recurring pneumothoraces.
While a pleurodesis can be accomplished arthroscopically, it is still considered a major surgery. Three small incisions are made at strategic points on the chest and back. Small cameras allow the surgery to be completed without resorting to a full thoracotomy.
During pleurodesis, the pleura is irritated either by scraping its surface or by using a chemical agent such as talc. This irritation causes scar tissue to form, resulting in the adhesion of the lung to the interior of the chest wall. The pleural cavity is thus eliminated, making a recurrence of the pneumothorax highly improbable.
Additionally, if blebs are found on the lung during a pleurodesis procedure, the surgeon will usually remove the affected lung section and staple the hole shut before adhering it to the chest wall.
Summary of Treatments for Different Sizes of Collapsed Lungs
A pneumothorax is a painful condition to endure and the treatments available require days to take effect. While a majority of those who suffer a pneumothorax will never suffer a recurrence, those unfortunate enough to suffer multiple lung collapses will usually be advised to accept a pleurodesis procedure.
This operation, while painful, will offer peace of mind to those who undergo it. The chance of a pneumothorax occurring in a person who has had a pleurodesis procedure is less than 1%.
Related Articles
- What Pulmonary Problems Cause a Pneumothorax? - describes the most common causes of a collapsed lung, these include stab and gunshot wounds, as well as proximity to powerful blasts and scuba diving accidents that change the internal pressure balance between the lungs and pleura
- How Do the Lungs and Breathing Actually Work? - gives a detailed description of the process of respiration, including the function of the lungs, chest wall, and pleura, and how a collapsed lung, also known as pneumothorax, can disrupt their normal function
Disclaimer: The information contained within this article is for educational purposes only, and is not intended to be a substitute in any way for care and treatment by a qualified health professional.
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