Pneumothorax: Types & Treatment

Pneumothorax is the medical term for a collapsed lung. This condition occurs when there is an abnormal collection of air in the pleural space between the lung and the chest wall. It is identified by a sudden attack of sharp, one-sided chest pain and shortness of breath. There are mainly two types of pneumothorax. They are traumatic pneumothorax and non-traumatic pneumothorax. Both these types can lead to a tension pneumothorax in case there is an increase in the air pressure surrounding the lung. A tension pneumothorax is usually observed in cases of trauma, and it requires emergency medical treatment. 

Traumatic pneumothorax:  Traumatic pneumothorax happens after some type of trauma or injury to the chest or lung wall. It can be a minor or very serious injury. The trauma can inflict damage on the chest structures which can result in air leaking into the pleural space. In case of external wounds or injuries, one may use the bactigras antiseptic dressing which soothes and protects the wound from infection and inflammation. A traumatic pneumothorax can be caused by trauma to the chest from a motor vehicle accident, broken ribs, a hard hit to the chest from a contact sport or a stab wound or bullet wound to the chest. Besides, changes in air pressure from scuba diving or mountain climbing can also cause a traumatic pneumothorax. Apart from these, there are certain medical procedures such as central line placement, lung biopsies, ventilator use, or CPR which can potentially damage the lung. A pneumothorax caused by serious chest trauma calls for emergency treatment as it could lead to potentially fatal complications such as respiratory failure, shock, cardiac arrest, and death. 

Non-traumatic pneumothorax This type of pneumothorax does not necessarily involve any injury. Instead, it happens spontaneously, due to some known or unknown underlying lung diseases. This is why it is also known as spontaneous pneumothorax. There are two types of spontaneous pneumothorax: primary and secondary. Primary spontaneous pneumothorax (PSP) is observed where the patient has no underlying lung disease history. Secondary spontaneous pneumothorax (SSP) tends to occur in older people with pre-existing lung conditions. Some medical conditions like asthma, lung cancer, chronic obstructive pulmonary diseases (COPD), and acute or chronic infection, such as tuberculosis or pneumonia increase the risk of secondary spontaneous pneumothorax. One may take the help of nebulizer machine online to help cope with medications for such type of lung conditions. There is a rare subtype of spontaneous pneumothorax that is known as spontaneous hemopneumothorax (SHP). It occurs when the pleural cavity is filled with both blood and air despite no recent trauma or history of lung disease. 

Treating pneumothorax The treatment of pneumothorax depends on the severity of the patient's condition. It also depends on whether the patient has experienced that earlier and the kind of symptoms they have. Both surgical and nonsurgical procedures are available. Let us understand the different treatment procedures: 

Observation: Observation is typically recommended for those with a small PSP and who are not experiencing shortness of breath. In this, the doctor monitors the patient's condition on a regular basis as the air absorbs from the pleural space. Frequent X-rays may be conducted to check if the lung has expanded fully again. The doctor may also advise against air travel until the condition is completely resolved. If the pneumothorax causes a drop in oxygen levels, oxygen may be administered. 

Draining excess air: Needle aspiration and insertion of chest tubes are two procedures to remove excess air from the pleural space. They can be done without requiring general anesthesia. 

Pleurodesis: Pleurodesis is a more invasive form of treatment usually recommended for individuals who have had repeated incidences of pneumothorax. In this, the doctor irritates the pleural space so that air and fluid can no longer accumulate. Once the pleura adheres to the chest wall, there is no further expansion of the pleural space. This prevents the formation of a future pneumothorax. 

Surgery Surgical treatment is required if the patient has experienced repeated spontaneous pneumothorax. It is also required when there is a large amount of air trapped in the chest cavity or some other lung condition. There are several types of surgery including thoracotomy, lobectomy as well as thoracoscopy, which is also known as video-assisted thoracoscopic surgery (VATS).