Pneumothorax During Anesthesia

Posted by e-Medical PPT
Pneumothorax is a collection of air or gas in the pleural cavity of the chest between the lung and the chest wall. It may occur spontaneously in people without chronic lung conditions  as well as in those with lung disease and many pneumothoraces occur after physical trauma to the chest, blast injury, or as a complication of medical treatment.
Primary spontaneous pneumothorax (PSP), which tends to occur in young people without underlying lung problems, usually causes limited symptoms. Chest pain and sometimes mild breathlessness are the predominant symptoms.Secondary spontaneous pneumothorax (SSP) occurs by definition in those with underlying lung diseases. The symptoms tend to be more severe, as the unaffected lung is generally not capable of replacing the loss of function from the affected side. Hypoxia is usually present and may be observed as cyanosis .Hypercapnia is sometimes encountered.Traumatic pneumothorax occurs either because a hole in the chest wall, such as a stab wound or gunshot wound, allows air to enter the pleural space, or because of injury to the lung. It has been found to occur in half of all cases of injury to the chest, coming second after rib fracture in the complications after chest trauma. Tension pneumothorax is characterized by rapid breathing, cyanosis, falling blood pressure (hypotension) and confusion. The affected side of the chest may be hyperexpanded and show decreased movement, with increased movement on the other side. In very severe cases, the respiratory rate falls sharply, with shock and coma.
Small spontaneous pneumothoraces typically resolve by themselves and require no treatment, especially in those with no underlying lung disease. In larger pneumothoraces or when there are severe symptoms, the air may be aspirated with a syringe, or a one-way chest tube is inserted to allow the air to escape. Occasionally, surgical measures are required, especially if tube drainage is unsuccessful or someone has repeated episodes. Various treatments, usually involving pleurodesis,may be used if there is a significant risk of repeated episodes of pneumothorax.

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